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TAMARA ELIZABETH LEISEY OTR/L
>> Massage Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1932408135
Individual Registrant: TAMARA ELIZABETH LEISEY OTR/L
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
22 SW 258TH ST NEWBERRY, FL 32669-4133 US
Tel: 352-474-6111 Fax: 352-474-6112
Tel: 352-474-6111 Fax: 352-474-6112
Contact information for business:
PO BOX 700 CHIEFLAND, FL 32644-0700 US
Tel: 352-490-7500 Fax: 352-490-7110
Tel: 352-490-7500 Fax: 352-490-7110
Registration Information:
NPI: 1932408135
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 225700000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Massage Therapist | FL | MA26936 |
| Y | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Occupational Therapist | FL | OT14482 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
