Provider Demographics
NPI:1700976529
Name:LEACH, ANNE DENISE (MS PT)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:DENISE
Last Name:LEACH
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:MS
Other - First Name:ANNE
Other - Middle Name:DENISE
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS PT
Mailing Address - Street 1:3614 WHITNEY WAY
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:NC
Mailing Address - Zip Code:28682-9821
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:825 W 25TH ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NC
Practice Address - Zip Code:28658-2852
Practice Address - Country:US
Practice Address - Phone:828-485-4594
Practice Address - Fax:828-464-5424
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0047712251P0200X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics