| Doctor Name: | GINA LEISING |
| NPI Number: | 1013251875 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MAT, CCC-SLP |
| License Number: | SLP8079 |
| Business Practice Address: | 10640 N 28th Dr C-104 Phoenix, AZ - 850294527 |
| Business Phone Number: | 6026268851 |
| Business Fax Number: | |
| Mailing Address: | 6126 W Park View Ln, GLENDALE |
| State: | AZ |
| Postal Code: | 853102701 |
| Phone Number: | 6238777547 |
| Fax Number: | |
| NPI Enumeration Date: | 11/19/2012 |
| NPI Last Update Date: | 11/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP8079 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |