Provider Demographics
NPI:1114532967
Name:LEAFE, KARLA RENEE
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:RENEE
Last Name:LEAFE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03246-2603
Mailing Address - Country:US
Mailing Address - Phone:603-524-9090
Mailing Address - Fax:
Practice Address - Street 1:25 MAIN ST
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NH
Practice Address - Zip Code:03049-6544
Practice Address - Country:US
Practice Address - Phone:603-465-7523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1583235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist