Healthcare Provider Details

I. General information

NPI: 1750702973
Provider Name (Legal Business Name): PATRICIA LEIGH PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2013
Last Update Date: 12/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6110 FALCONBRIDGE RD SUITE 100
CHAPEL HILL NC
27517-7875
US

IV. Provider business mailing address

6110 FALCONBRIDGE RD SUITE 100
CHAPEL HILL NC
27517-7875
US

V. Phone/Fax

Practice location:
  • Phone: 919-401-9933
  • Fax: 919-402-0249
Mailing address:
  • Phone: 919-401-9933
  • Fax: 919-402-0249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number10520
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: