Provider Demographics
NPI:1245498732
Name:TARSITANO, LEONORA M (OTR)
Entity type:Individual
Prefix:MRS
First Name:LEONORA
Middle Name:M
Last Name:TARSITANO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5453 FREELAND AVE
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:WA
Mailing Address - Zip Code:98249-9736
Mailing Address - Country:US
Mailing Address - Phone:303-621-4991
Mailing Address - Fax:
Practice Address - Street 1:5453 FREELAND AVE
Practice Address - Street 2:
Practice Address - City:FREELAND
Practice Address - State:WA
Practice Address - Zip Code:98249-9736
Practice Address - Country:US
Practice Address - Phone:303-621-4991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD997911225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist