MEDICARE: KATHRYN S LEIGH

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
1	235Z00000X	Speech-Language Pathologist	2359	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548383987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN S LEIGH

Provider Business Mailing Address
First Line	:	13 KINGS PARK LN
Second Line	:
City	:	CONWAY
State	:	AR
Zip	:	72034-3451
Country	:	US
Telephone Number	:	501-358-2376
Fax Number	:

Provider Business Practice Location Address
First Line	:	13 KINGS PARK LN
Second Line	:
City	:	CONWAY
State	:	AR
Zip	:	72034-3451
Country	:	US
Telephone Number	:	501-581-6045
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	09/10/2024

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Directions to “ KATHRYN S LEIGH ” Practice Location

Language	Start Address	Practice Location

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