Provider Demographics
NPI:1114132354
Name:LEADFORD, JULIA HENSLEY (SLP)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:HENSLEY
Last Name:LEADFORD
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 1:102 WILLOW SPRING CIR
Mailing Address - Street 2:
Mailing Address - City:PAULS VALLEY
Mailing Address - State:OK
Mailing Address - Zip Code:73075-5316
Mailing Address - Country:US
Mailing Address - Phone:405-238-6760
Mailing Address - Fax:
Practice Address - Street 1:1020 S CHICKASAW ST
Practice Address - Street 2:
Practice Address - City:PAULS VALLEY
Practice Address - State:OK
Practice Address - Zip Code:73075-5821
Practice Address - Country:US
Practice Address - Phone:405-207-9957
Practice Address - Fax:405-207-9447
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK502235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist