Provider Demographics
NPI:1598403727
Name:SMITH, LEAH MICHELLE (MS)
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:MICHELLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 S CUSTER RD STE 903
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75072-1455
Mailing Address - Country:US
Mailing Address - Phone:469-215-7669
Mailing Address - Fax:
Practice Address - Street 1:1402 S CUSTER RD STE 903
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75072-1455
Practice Address - Country:US
Practice Address - Phone:469-215-7669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117306235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist