Provider Demographics
NPI:1487096939
Name:LEONARD, CHELSEA MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:MARIE
Last Name:LEONARD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:MARIE
Other - Last Name:STOECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:109 ROSE LANE TER
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13219-2845
Mailing Address - Country:US
Mailing Address - Phone:315-246-5988
Mailing Address - Fax:
Practice Address - Street 1:1603 COURT ST
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13208-1834
Practice Address - Country:US
Practice Address - Phone:315-455-7591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018178225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist