Provider Demographics
NPI:1275948820
Name:BLAIR, LEAHLI
Entity Type:Individual
Prefix:
First Name:LEAHLI
Middle Name:
Last Name:BLAIR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 SHUMAN BLVD
Mailing Address - Street 2:STE. 401
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-8458
Mailing Address - Country:US
Mailing Address - Phone:630-303-5380
Mailing Address - Fax:978-313-6824
Practice Address - Street 1:1719 S LOOP 288
Practice Address - Street 2:STE. 165
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-4809
Practice Address - Country:US
Practice Address - Phone:940-566-2425
Practice Address - Fax:940-566-2425
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist