Provider Demographics
NPI:1407872906
Name:LAFFERTY, LEANNE M (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:M
Last Name:LAFFERTY
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:LEANNE
Other - Middle Name:M
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:131 WHITE BIRCH PL
Mailing Address - Street 2:
Mailing Address - City:CASHMERE
Mailing Address - State:WA
Mailing Address - Zip Code:98815-1104
Mailing Address - Country:US
Mailing Address - Phone:509-670-3478
Mailing Address - Fax:
Practice Address - Street 1:131 WHITE BIRCH PL
Practice Address - Street 2:
Practice Address - City:CASHMERE
Practice Address - State:WA
Practice Address - Zip Code:98815-1104
Practice Address - Country:US
Practice Address - Phone:509-670-3478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004255235500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0209874OtherL&I