Provider Demographics
NPI:1003090598
Name:LEFFINGWELL, SHARON (MA,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:
Last Name:LEFFINGWELL
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1328 WOLF RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:COLLIERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38017-6813
Mailing Address - Country:US
Mailing Address - Phone:901-861-6517
Mailing Address - Fax:
Practice Address - Street 1:1328 WOLF RIDGE DR
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-6813
Practice Address - Country:US
Practice Address - Phone:901-861-6517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001505235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist