Provider Demographics
NPI:1366917643
Name:LEEMAN, DINA ILIANA (OTR/L, MS, CBIS, LSV)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:ILIANA
Last Name:LEEMAN
Suffix:
Gender:F
Credentials:OTR/L, MS, CBIS, LSV
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:11 LONGWOOD AVE PH 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-5281
Mailing Address - Country:US
Mailing Address - Phone:781-307-1014
Mailing Address - Fax:
Practice Address - Street 1:51 WATER ST STE 205
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-4611
Practice Address - Country:US
Practice Address - Phone:617-774-8300
Practice Address - Fax:617-744-6218
Is Sole Proprietor?:No
Enumeration Date:2018-10-12
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12806225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation