Basic Information
| Provider Information | |||||||||
| NPI: | 1740892322 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEMAN | ||||||||
| FirstName: | LETISHA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 CARIBOU LAKE RD | ||||||||
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| City: | CARIBOU | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047364262 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078372341 | ||||||||
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| Practice Location | |||||||||
| Address1: | 163 VAN BUREN RD | ||||||||
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| City: | CARIBOU | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047363567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2074981618 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2020 | ||||||||
| LastUpdateDate: | 08/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT3823 | ME | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.