Provider Demographics
NPI:1164629564
Name:LEILA L. HARTLEY, PH.D. & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:LEILA L. HARTLEY, PH.D. & ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LEILA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HARTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-812-9875
Mailing Address - Street 1:PO BOX 19037
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31126-1037
Mailing Address - Country:US
Mailing Address - Phone:404-812-9875
Mailing Address - Fax:404-812-1979
Practice Address - Street 1:245 W WIEUCA RD NE
Practice Address - Street 2:SUITE 150
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-3321
Practice Address - Country:US
Practice Address - Phone:404-812-9875
Practice Address - Fax:404-812-1979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP003516235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty