Provider Demographics
NPI:1356476972
Name:BLINN, LEAH MICHELLE
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:MICHELLE
Last Name:BLINN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:BLINN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA CCC SLP
Mailing Address - Street 1:494 ENGLE RD
Mailing Address - Street 2:
Mailing Address - City:INDUSTRY
Mailing Address - State:PA
Mailing Address - Zip Code:15052-1800
Mailing Address - Country:US
Mailing Address - Phone:412-361-3761
Mailing Address - Fax:
Practice Address - Street 1:1417 WIGHTMAN ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1240
Practice Address - Country:US
Practice Address - Phone:412-421-0310
Practice Address - Fax:412-421-0312
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008543235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist