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General NPI Number Information
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NPI Number | 1821461641
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Entity Type | Individual
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Provider Name | LEILA HARTLEY PH.D.
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Gender | Female
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Dates
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Enumeration Date | 11/02/2015
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Last Update Date | 11/02/2015
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Provider Practice Location Address
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Address Line | 245 W WIEUCA RD NE SUITE 150
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City | ATLANTA
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State | GA
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Zip | 30342-3372
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Country | US
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Telephone | 404-812-9875
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Fax | 404-841-1944
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Provider Business Mailing Address
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Address Line | PO BOX 19037
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City | ATLANTA
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State | GA
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Zip | 31126-1037
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Country | US
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Telephone | 404-812-9875
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Fax | 404-841-1944
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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 | SLP003516
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License Number State | GA
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