Provider Demographics
NPI:1730933474
Name:HOOD, LESLIE NICOLE (OTR/L)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:NICOLE
Last Name:HOOD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:NICOLE
Other - Last Name:MARINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2100 EXETER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-3966
Mailing Address - Country:US
Mailing Address - Phone:901-522-6440
Mailing Address - Fax:901-757-2507
Practice Address - Street 1:1355 LYNNFIELD RD STE 187
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5883
Practice Address - Country:US
Practice Address - Phone:901-761-4263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3232225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist