Provider Demographics
NPI:1083952170
Name:SIMINGTON-LEROY, LASHAWN ANNETTE (SLP)
Entity Type:Individual
Prefix:MS
First Name:LASHAWN
Middle Name:ANNETTE
Last Name:SIMINGTON-LEROY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 ASHLAND WAY
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-1314
Mailing Address - Country:US
Mailing Address - Phone:678-663-6449
Mailing Address - Fax:
Practice Address - Street 1:315 UPPER RIVERDALE RD SW
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-2500
Practice Address - Country:US
Practice Address - Phone:770-991-2636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006327235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist