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General NPI Number Information
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NPI Number | 1235709759
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Entity Type | Organization
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Legal Business Name | JENNIFER A. LEIGH, M.S. CCC-SLP, INC.
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Dates
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Enumeration Date | 06/28/2021
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Last Update Date | 06/28/2021
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Provider Practice Location Address
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Address Line | 7243 US HIGHWAY 301 S STE A
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City | RIVERVIEW
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State | FL
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Zip | 33578-8399
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Country | US
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Telephone | 813-663-9828
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Fax | 888-965-6670
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Provider Business Mailing Address
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Address Line | 7243 US HIGHWAY 301 S STE A
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City | RIVERVIEW
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State | FL
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Zip | 33578-8399
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Country | US
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Telephone | 813-663-9828
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Fax | 888-965-6670
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | BETHANY LEAVITT
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Credential |
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Telephone | 813-663-9828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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