Provider Demographics
NPI:1952597007
Name:LEASHEFSKI, CAROL A (OTR/L)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:A
Last Name:LEASHEFSKI
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 1:153 LUCINDA LN
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-1026
Mailing Address - Country:US
Mailing Address - Phone:610-670-5209
Mailing Address - Fax:610-927-9706
Practice Address - Street 1:153 LUCINDA LN
Practice Address - Street 2:
Practice Address - City:WYOMISSING
Practice Address - State:PA
Practice Address - Zip Code:19610-1026
Practice Address - Country:US
Practice Address - Phone:610-670-5209
Practice Address - Fax:610-927-9706
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-22
Last Update Date:2007-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC002424L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist