Provider Demographics
NPI:1154843308
Name:LEARY, RESHELLA DAWN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RESHELLA
Middle Name:DAWN
Last Name:LEARY
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 1:100 MOUNT CLINTON PIKE
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22802-2507
Mailing Address - Country:US
Mailing Address - Phone:540-564-3250
Mailing Address - Fax:
Practice Address - Street 1:9508 SPOTSWOOD TRL
Practice Address - Street 2:
Practice Address - City:MCGAHEYSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22840-2407
Practice Address - Country:US
Practice Address - Phone:540-289-3004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2017-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006058235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist