Ms Leslie Ann Wallace, OT - Occupational Therapist in Ronan, MT

Ms Leslie Ann Wallace, OT is a Occupational Therapist - Pediatrics based in Ronan, Montana. Ms Leslie Ann Wallace is licensed to practice in Montana (license number 186) and her current practice location is 43922 Canal Rd, Ronan, Montana. She can be reached at her office (for appointments etc.) via phone at (406) 676-2912.

NPI number for Ms Leslie Ann Wallace is 1750444956 and her current mailing address is 43922 Canal Rd, Ronan, Montana. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1750444956.

Contact Information

Ms Leslie Ann Wallace, OT
43922 Canal Rd,
Ronan, MT 59864-9192
(406) 676-2912
(406) 676-2912



Healthcare Provider's Profile

Full NameMs Leslie Ann Wallace
GenderFemale
SpecialityOccupational Therapist - Pediatrics
Location43922 Canal Rd, Ronan, Montana
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1750444956
  • Provider Enumeration Date: 12/18/2006
  • Last Update Date: 07/09/2007

Medical Identifiers

Medical identifiers for Ms Leslie Ann Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1750444956NPI-NPPES
0341343MedicaidMT
66351OtherMTBCBS PROVIDER NUMBER

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225X00000XOccupational Therapist 186 (Montana)Primary
225XP0200XOccupational Therapist - Pediatrics 186 (Montana)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Leslie Ann Wallace is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ms Leslie Ann Wallace, OT
43922 Canal Rd,
Ronan, MT 59864-9192

Ph: (406) 676-2912
Ms Leslie Ann Wallace, OT
43922 Canal Rd,
Ronan, MT 59864-9192

Ph: (406) 676-2912

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› Verified 4 days ago


Occupational Therapist in Ronan, MT

Ms. Shannon Marie Harris, MOTR/L
Occupational Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 107 6th Ave Sw, Ronan, MT 59864
Phone: 406-676-4441    
Ms. Taylor E Clough,
Occupational Therapist
Medicare: Medicare Enrolled
Practice Location: 107 6th Ave Sw, Ronan, MT 59864
Phone: 406-676-4441    Fax: 406-676-0835

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