Individual
KAILEY JO LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
17835 179TH TRL W, LAKEVILLE, MN 55044-5207
(952) 435-1999
Mailing address
17835 179TH TRL W, LAKEVILLE, MN 55044-5207
(952) 215-2530
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14314497
MN
Other
Enumeration date
03/31/2022
Last updated
03/31/2022
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