Provider Demographics
NPI:1811140023
Name:KITAINIK, LEAH (OTR/L)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:KITAINIK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 SUMMIT POINTE DR
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-7263
Mailing Address - Country:US
Mailing Address - Phone:702-997-5911
Mailing Address - Fax:
Practice Address - Street 1:6200 W OAKEY BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1103
Practice Address - Country:US
Practice Address - Phone:702-507-2731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV090064225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist