Provider Demographics
NPI:1841575941
Name:USTICK, LEIGH BLANCHE FLECHSIG (OTR/L)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:BLANCHE FLECHSIG
Last Name:USTICK
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:BLANCHE
Other - Last Name:FLECHSIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:20 HADSELL DRIVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302
Mailing Address - Country:US
Mailing Address - Phone:248-867-9054
Mailing Address - Fax:248-988-8583
Practice Address - Street 1:20 HADSELL DRIVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302
Practice Address - Country:US
Practice Address - Phone:248-867-9054
Practice Address - Fax:248-988-8583
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-20
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201008103225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist