Provider Demographics
NPI:1598334435
Name:LEON HAUG, LILLIAM
Entity Type:Individual
Prefix:
First Name:LILLIAM
Middle Name:
Last Name:LEON HAUG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8483 NW 191ST ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33015-5369
Mailing Address - Country:US
Mailing Address - Phone:786-316-2846
Mailing Address - Fax:
Practice Address - Street 1:1830 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3569
Practice Address - Country:US
Practice Address - Phone:786-542-5185
Practice Address - Fax:786-542-5540
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI39842355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant