Doctor Name: | LEIGH BLACKBURN |
NPI Number: | 1477617132 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.ED., CCC-SLP |
License Number: | SLP006107 |
Business Practice Address: | 601 N Belair Sq Ste 19 Evans, GA - 308094324 |
Business Phone Number: | 7063641486 |
Business Fax Number: | 7063641487 |
Mailing Address: | 3752 Roscommon S, MARTINEZ |
State: | GA |
Postal Code: | 309074742 |
Phone Number: | 7063641486 |
Fax Number: | 7063641487 |
NPI Enumeration Date: | 12/20/2006 |
NPI Last Update Date: | 10/16/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP006107 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
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 |