Provider Demographics
NPI:1548777238
Name:HALL-LEONARD, ANDREA (MA)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:
Last Name:HALL-LEONARD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:VA
Mailing Address - Zip Code:23851-2608
Mailing Address - Country:US
Mailing Address - Phone:757-774-8925
Mailing Address - Fax:
Practice Address - Street 1:SOUTHAMPTON COUNTY PUBLIC SCHOOLS 21290 PLANK ROAD
Practice Address - Street 2:
Practice Address - City:COURTLAND
Practice Address - State:VA
Practice Address - Zip Code:23837
Practice Address - Country:US
Practice Address - Phone:757-774-8925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2203000590235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist