Provider Demographics
NPI:1376775882
Name:FRIENER, LEIGHA (MA-CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LEIGHA
Middle Name:
Last Name:FRIENER
Suffix:
Gender:F
Credentials:MA-CCC-SLP
Other - Prefix:
Other - First Name:LEIGHA
Other - Middle Name:
Other - Last Name:FRANCIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA-CCC-SLP
Mailing Address - Street 1:100 N HUMPHREYS BLVD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2146
Mailing Address - Country:US
Mailing Address - Phone:901-747-1800
Mailing Address - Fax:
Practice Address - Street 1:2965 N GERMANTOWN RD STE 124
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38133-4055
Practice Address - Country:US
Practice Address - Phone:901-683-8787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP 0000004495235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN179219721Medicaid