Provider Demographics
NPI:1679911358
Name:ROOK, LEAHANNA (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:LEAHANNA
Middle Name:
Last Name:ROOK
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 1:14 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-4009
Mailing Address - Country:US
Mailing Address - Phone:646-334-7852
Mailing Address - Fax:
Practice Address - Street 1:14 PARK AVE
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-4009
Practice Address - Country:US
Practice Address - Phone:646-334-7852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-04
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018023252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency