Individual
LEAH ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3003 32ND AVE S STE 9, FARGO, ND 58103-6163
(701) 232-2340
Mailing address
4804 51ST AVE S, FARGO, ND 58104-6023
(701) 866-3868
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TSLPL5092
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124953
—
AZ
Enumeration date
03/01/2007
Last updated
04/21/2010
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