Provider Demographics
NPI:1073860789
Name:CABOT, LEAH MARIE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:MARIE
Last Name:CABOT
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 W ROUTT AVE
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81004-1551
Mailing Address - Country:US
Mailing Address - Phone:719-423-0444
Mailing Address - Fax:
Practice Address - Street 1:221 S UNION AVE
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81003-3490
Practice Address - Country:US
Practice Address - Phone:719-545-1114
Practice Address - Fax:719-546-6154
Is Sole Proprietor?:No
Enumeration Date:2012-08-13
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19012235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist