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NPI Code Detail

MEDICARE: MRS. ELIZABETH MICHELLE LEON-KIRTLAND M.S., CF-SLP

MEDICARE: MRS. ELIZABETH MICHELLE LEON-KIRTLAND M.S., CF-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2235Z00000XSpeech-Language Pathologist2204000443VA

General Provider Information

NPI Number : 1194996074
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELIZABETH MICHELLE LEON-KIRTLAND M.S., CF-SLP
Provider Business Mailing Address
First Line : 5604 VIRGINIA BEACH BLVD STE 101
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-5631
Country : US
Telephone Number : 757-455-5000
Fax Number : 757-319-4142
Provider Business Practice Location Address
First Line : 5604 VIRGINIA BEACH BLVD STE 101
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23462-5631
Country : US
Telephone Number : 757-455-5000
Fax Number : 757-319-4142
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2008
Last Update Date : 05/15/2020

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Directions to “ MRS. ELIZABETH MICHELLE LEON-KIRTLAND M.S., CF-SLP” Practice Location

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