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NPI Code Detail

MEDICARE: DEBORAH JANE LEAHY

MEDICARE: DEBORAH JANE LEAHY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist818MA

General Provider Information

NPI Number : 1093277030
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH JANE LEAHY
Provider Business Mailing Address
First Line : 11 LARSON LN
Second Line :
City : STONEHAM
State : MA
Zip : 02180-2173
Country : US
Telephone Number : 781-475-0426
Fax Number :
Provider Business Practice Location Address
First Line : 465 WAVERLY OAKS RD STE 101
Second Line :
City : WALTHAM
State : MA
Zip : 02452-8497
Country : US
Telephone Number : 781-894-6564
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2019
Last Update Date : 04/01/2019

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Directions to “ DEBORAH JANE LEAHY ” Practice Location

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