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General NPI Number Information
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NPI Number | 1902411101
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Entity Type | Organization
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Legal Business Name | LEAP OF LANGUAGE INC
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Dates
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Enumeration Date | 09/14/2020
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 37171 SYCAMORE ST APT 633
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City | NEWARK
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State | CA
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Zip | 94560-3974
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Country | US
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Telephone | 205-534-4330
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Fax |
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Provider Business Mailing Address
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Address Line | 37171 SYCAMORE ST APT 633
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City | NEWARK
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State | CA
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Zip | 94560-3974
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Country | US
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Telephone | 205-534-4330
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JESSICA S PATRICK
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Credential | M.S., CCC-SLP
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Telephone | 205-534-4330
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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 |
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License Number State |
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