Provider Demographics
NPI:1225383466
Name:LEAPS WITH LANGUAGE
Entity Type:Organization
Organization Name:LEAPS WITH LANGUAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:NITSCHKE
Authorized Official - Suffix:
Authorized Official - Credentials:MS CCC
Authorized Official - Phone:512-573-7486
Mailing Address - Street 1:4107 MEDICAL PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3729
Mailing Address - Country:US
Mailing Address - Phone:512-573-7486
Mailing Address - Fax:
Practice Address - Street 1:4107 MEDICAL PKWY STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3729
Practice Address - Country:US
Practice Address - Phone:512-573-7486
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100867261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech