Provider Demographics
NPI:1043983307
Name:CHAPPELL, LEIGH ANN MICHELLE (MA, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:LEIGH ANN
Middle Name:MICHELLE
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:LEIGH ANN
Other - Middle Name:MICHELLE
Other - Last Name:DUNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC/SLP
Mailing Address - Street 1:PO BOX 456
Mailing Address - Street 2:
Mailing Address - City:FOURMILE
Mailing Address - State:KY
Mailing Address - Zip Code:40939-0456
Mailing Address - Country:US
Mailing Address - Phone:859-200-8344
Mailing Address - Fax:
Practice Address - Street 1:235 NEW WILSON LN
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-2705
Practice Address - Country:US
Practice Address - Phone:606-248-0925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY3135235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty