Provider Demographics
NPI:1386126225
Name:CARTER, LESLIE KATHRYN (OTR/L)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:KATHRYN
Last Name:CARTER
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 1:9300 N STAR DR
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-2822
Mailing Address - Country:US
Mailing Address - Phone:301-640-6770
Mailing Address - Fax:
Practice Address - Street 1:2220 EDWARD HOLLAND DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-2519
Practice Address - Country:US
Practice Address - Phone:804-578-6514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119007322225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty