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General NPI Number Information
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NPI Number | 1821468570
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Entity Type | Individual
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Provider Name | LEAH ROTHWELL MA,CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/06/2015
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Last Update Date | 04/27/2020
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Provider Practice Location Address
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Address Line | 101 SUMMIT AVE 510
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City | FT WORTH
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State | TX
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Zip | 76102-2618
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Country | US
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Telephone | 682-730-0009
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Fax |
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Provider Business Mailing Address
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Address Line | 18725 DALLAS PKWY 1413
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City | DALLAS
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State | TX
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Zip | 75287-4239
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Country | US
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Telephone | 407-285-9086
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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 | 110550
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP25632
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License Number State | CA
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