Provider Demographics
NPI:1144435777
Name:CHAPMAN, MARY LEAH (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:LEAH
Last Name:CHAPMAN
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 1:1000 LEAH LN
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-7846
Mailing Address - Country:US
Mailing Address - Phone:512-218-4396
Mailing Address - Fax:
Practice Address - Street 1:1611 HEADWAY CIR BLDG 2
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-5165
Practice Address - Country:US
Practice Address - Phone:512-478-2581
Practice Address - Fax:512-476-1638
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15845235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX454587Medicare ID - Type Unspecified