Provider Demographics
NPI:1477825883
Name:LEAUTAUD, JOSEFINA (MS SLP)
Entity Type:Individual
Prefix:MS
First Name:JOSEFINA
Middle Name:
Last Name:LEAUTAUD
Suffix:
Gender:F
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 S HALE AVE
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:IL
Mailing Address - Zip Code:60103-4222
Mailing Address - Country:US
Mailing Address - Phone:630-550-3168
Mailing Address - Fax:
Practice Address - Street 1:118 S HALE AVE
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-4222
Practice Address - Country:US
Practice Address - Phone:630-550-3168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-31
Last Update Date:2012-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist