Provider Demographics
NPI:1487286621
Name:HYLTON, LEANDRA (OTR/L)
Entity type:Individual
Prefix:
First Name:LEANDRA
Middle Name:
Last Name:HYLTON
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 1:32 HARVEST WOODS RD
Mailing Address - Street 2:
Mailing Address - City:ROCKFALL
Mailing Address - State:CT
Mailing Address - Zip Code:06481-2051
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:181 SHUNPIKE RD
Practice Address - Street 2:
Practice Address - City:CROMWELL
Practice Address - State:CT
Practice Address - Zip Code:06416-1143
Practice Address - Country:US
Practice Address - Phone:860-632-8243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5374225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist