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NPI Code Detail

MEDICARE: HEATHER LEANN LEONHART M.S. CCC-SLP

MEDICARE: HEATHER LEANN LEONHART M.S. CCC-SLP
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 Pathologist0361WV

General Provider Information

NPI Number : 1770600892
Entity Type Code : Individual
Provider Name (Legal Business Name) : HEATHER LEANN LEONHART M.S. CCC-SLP
Provider Business Mailing Address
First Line : 1621 VIRGINIA ST E APT 12
Second Line :
City : CHARLESTON
State : WV
Zip : 25311-2109
Country : US
Telephone Number : 304-416-0112
Fax Number :
Provider Business Practice Location Address
First Line : 1000 LINCOLN DR
Second Line :
City : CHARLESTON
State : WV
Zip : 25309-2304
Country : US
Telephone Number : 304-768-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2007
Last Update Date : 07/08/2007

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Directions to “ HEATHER LEANN LEONHART M.S. CCC-SLP” Practice Location

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