Provider Demographics
NPI:1730409061
Name:NEAL, LEAH (OT)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:NEAL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6885 CATAMARAN DR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-3218
Mailing Address - Country:US
Mailing Address - Phone:760-613-5549
Mailing Address - Fax:
Practice Address - Street 1:1785 S ESCONDIDO BLVD STE A
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-6573
Practice Address - Country:US
Practice Address - Phone:760-740-0055
Practice Address - Fax:760-740-0066
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 7268225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist