Provider Demographics
NPI:1841697232
Name:LEBLANC, JULIE ANNE (MS, OTR/L)
Entity type:Individual
Prefix:MS
First Name:JULIE
Middle Name:ANNE
Last Name:LEBLANC
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:MRS
Other - First Name:JULIE
Other - Middle Name:ANNE
Other - Last Name:LEBLANC-SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2850 W HORIZON RIDGE PKWY STE 320
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4395
Mailing Address - Country:US
Mailing Address - Phone:228-223-3271
Mailing Address - Fax:
Practice Address - Street 1:2850 W HORIZON RIDGE PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4395
Practice Address - Country:US
Practice Address - Phone:228-223-3271
Practice Address - Fax:228-452-6294
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-01
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT1451224ZL0004X, 225X00000X
NVOT3088225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224ZL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantLow Vision