Provider Demographics
NPI:1316582703
Name:DENEAL, KALEIGH ELLA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KALEIGH
Middle Name:ELLA
Last Name:DENEAL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 S LEDFORD ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:IL
Mailing Address - Zip Code:62946-3154
Mailing Address - Country:US
Mailing Address - Phone:618-771-7800
Mailing Address - Fax:
Practice Address - Street 1:792 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ANNA
Practice Address - State:IL
Practice Address - Zip Code:62906-1627
Practice Address - Country:US
Practice Address - Phone:618-833-6302
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-09
Last Update Date:2019-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146014524235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist