| Doctor Name: | MS. SHELLY M. LEITCH |
| NPI Number: | 1346307634 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN, MSN, CPNP |
| License Number: | 453991 |
| Business Practice Address: | 416 Highway 87 Teen Health Center, Inc.-crenshaw Crystal Beach, TX - 77650 |
| Business Phone Number: | 4097665750 |
| Business Fax Number: | |
| Mailing Address: | 300 Seacrest Blvd, LEAGUE CITY |
| State: | TX |
| Postal Code: | 775739231 |
| Phone Number: | 2815382722 |
| Fax Number: | |
| NPI Enumeration Date: | 01/03/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | 453991 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |