Provider Demographics
NPI:1346402344
Name:HICKS, LEIGH ANN (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LEIGH
Middle Name:ANN
Last Name:HICKS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 ROSEHILL LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40514-1170
Mailing Address - Country:US
Mailing Address - Phone:859-361-4036
Mailing Address - Fax:
Practice Address - Street 1:3805 ROSEHILL LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40514-1170
Practice Address - Country:US
Practice Address - Phone:859-361-4036
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-3423235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist