Provider Demographics
NPI:1598881484
Name:SOTO, KENYA LEIGH (CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:KENYA
Middle Name:LEIGH
Last Name:SOTO
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:MS
Other - First Name:KENYA
Other - Middle Name:LEIGH
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC SLP
Mailing Address - Street 1:120 ARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-2106
Mailing Address - Country:US
Mailing Address - Phone:318-347-2458
Mailing Address - Fax:
Practice Address - Street 1:463 ASHLEY RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-7231
Practice Address - Country:US
Practice Address - Phone:318-671-8772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6719235Z00000X
TX100535235Z00000X
LA5852235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist