Provider Demographics
NPI:1164854022
Name:PANETTI, LEIGH ANN (MA)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANN
Last Name:PANETTI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:937 MENOHER BLVD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905-2838
Mailing Address - Country:US
Mailing Address - Phone:814-255-9559
Mailing Address - Fax:814-255-5400
Practice Address - Street 1:937 MENOHER BLVD
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15905-2838
Practice Address - Country:US
Practice Address - Phone:814-255-9559
Practice Address - Fax:814-255-5400
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2013-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008867235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist