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General NPI Number Information
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NPI Number | 1386265320
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Entity Type | Individual
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Provider Name | MOLLY SWANN LEEUWENBURG SLP
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Gender | Female
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Dates
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Enumeration Date | 04/30/2020
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 13995 W STATLER BLVD STE 100
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City | SURPRISE
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State | AZ
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Zip | 85374-5501
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Country | US
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Telephone | 480-787-5387
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Fax |
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Provider Business Mailing Address
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Address Line | 9150 W INDIAN SCHOOL RD STE 130
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City | PHOENIX
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State | AZ
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Zip | 85037-2388
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Country | US
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Telephone | 480-787-5387
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP15920
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License Number State | AZ
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