Healthcare Provider Details

I. General information

NPI: 1972430080
Provider Name (Legal Business Name): LEAH HAMILTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 STILLWATER BLVD N
STILLWATER MN
55082-1030
US

IV. Provider business mailing address

1875 GREELEY ST S
STILLWATER MN
55082-6079
US

V. Phone/Fax

Practice location:
  • Phone: 651-351-8249
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: