Provider Demographics
NPI:1881996437
Name:STURGEON, LEAH J (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:J
Last Name:STURGEON
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 1:1822 CROSS GREEN WAY
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-4958
Mailing Address - Country:US
Mailing Address - Phone:904-264-1200
Mailing Address - Fax:
Practice Address - Street 1:1822 CROSS GREEN WAY
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-4958
Practice Address - Country:US
Practice Address - Phone:904-264-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT10366225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist