Provider Demographics
NPI:1164034815
Name:SHERWOOD, LEAH MARIE (AUD)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:MARIE
Last Name:SHERWOOD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:MARIE
Other - Last Name:HYSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1108 W DIXIE AVE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-6312
Mailing Address - Country:US
Mailing Address - Phone:352-326-5253
Mailing Address - Fax:352-323-0895
Practice Address - Street 1:1108 W DIXIE AVE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-6312
Practice Address - Country:US
Practice Address - Phone:352-326-5253
Practice Address - Fax:352-323-0895
Is Sole Proprietor?:No
Enumeration Date:2020-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY2400231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist