Doctor Name: | JEAN L LEARY |
NPI Number: | 1528282019 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. CCC-SLP |
License Number: | SP11718 |
Business Practice Address: | 25825 Vermont Ave Harbor City, CA - 907103518 |
Business Phone Number: | 3105173922 |
Business Fax Number: | |
Mailing Address: | 702 N Paulina Ave, Apt B REDONDO BEACH |
State: | CA |
Postal Code: | 902772247 |
Phone Number: | 3103743057 |
Fax Number: | 3103183452 |
NPI Enumeration Date: | 04/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP11718 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
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 |