Healthcare Provider Details

I. General information

NPI: 1871853069
Provider Name (Legal Business Name): LEANNE FOSTER-ABRAHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2012
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1894 LUDOVIE LN
DECATUR GA
30033-1044
US

IV. Provider business mailing address

1894 LUDOVIE LN
DECATUR GA
30033-1044
US

V. Phone/Fax

Practice location:
  • Phone: 678-626-0557
  • Fax: 678-288-7932
Mailing address:
  • Phone: 678-626-0557
  • Fax: 678-288-7932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP011344
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: