Individual
LEAH GANTJOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
16760 LINCOLN ST, GRAND HAVEN, MI 49417-8864
(616) 935-3300
(616) 935-3333
Mailing address
1377 MOTOR PKWY STE 307, ISLANDIA, NY 11749-5258
(631) 580-5200
(631) 580-5222
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7151013486
MI
Other
Enumeration date
03/03/2021
Last updated
03/03/2021
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