Provider Demographics
NPI:1740314517
Name:MOSBY, LEKESIAH NELSON (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:LEKESIAH
Middle Name:NELSON
Last Name:MOSBY
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:KESIAH
Other - Middle Name:
Other - Last Name:MOSBY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTR/L
Mailing Address - Street 1:385 SABLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-8048
Mailing Address - Country:US
Mailing Address - Phone:770-377-7628
Mailing Address - Fax:
Practice Address - Street 1:385 SABLEWOOD DR
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-8048
Practice Address - Country:US
Practice Address - Phone:770-377-7628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOT004928225XN1300X, 225XP0019X, 225XP0200X, 225X00000X, 171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No171W00000XOther Service ProvidersContractor