Individual
MRS. KATHY SUZANNE LEAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SPEECH THERAPIST
Contact information
Practice address
158 PRIMARY SCHOOL DR, MADISON, VA 22727-3008
(540) 948-3781
Mailing address
261 BOXLEY LN, ORANGE, VA 22960-1103
(540) 672-7295
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
—
—
235Z00000X
Speech-Language Pathologist
Primary
2203000317
VA
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
09/03/2018
Last updated
09/03/2018
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