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Individual

MISS DENISE KIRK LEASURE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CCC.SLP

Contact information

Practice address
769 CLEARVIEW DR, CHARLESTON, SC 29412-4545
(843) 442-1052
Mailing address
769 CLEARVIEW DR, CHARLESTON, SC 29412-4545
(843) 442-1052

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2955
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
SAO275
SC
Enumeration date
01/18/2007
Last updated
03/19/2009
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