Provider Demographics
NPI:1952675621
Name:JENKINS, LESLI MARI (OTR)
Entity Type:Individual
Prefix:MRS
First Name:LESLI
Middle Name:MARI
Last Name:JENKINS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 COSBIE DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-5349
Mailing Address - Country:US
Mailing Address - Phone:469-774-9615
Mailing Address - Fax:469-359-1016
Practice Address - Street 1:304 COSBIE DR
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-5349
Practice Address - Country:US
Practice Address - Phone:469-774-9615
Practice Address - Fax:469-359-1016
Is Sole Proprietor?:No
Enumeration Date:2012-02-28
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112595225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist