Healthcare Provider Details
I. General information
NPI: 1760503148
Provider Name (Legal Business Name): CHERYL ANN LEEPER M.S., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/03/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1601 W. ST. MARY'S RD.
TUCSON AZ
85745
US
IV. Provider business mailing address
1601 W. ST. MARY'S RD.
TUCSON AZ
85745
US
V. Phone/Fax
- Phone: 520-872-2256
- Fax: 520-872-4968
- Phone: 520-872-2256
- Fax: 520-872-4968
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | DA1959 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: