Provider Demographics
NPI:1659501716
Name:WHITEMAN, LEAH DUNCAN (MS SLP-CCC)
Entity Type:Individual
Prefix:MS
First Name:LEAH
Middle Name:DUNCAN
Last Name:WHITEMAN
Suffix:
Gender:F
Credentials:MS SLP-CCC
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:KATHLEEN
Other - Last Name:DUNCAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1405 N PARKFOREST WAY
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:ID
Mailing Address - Zip Code:83616-4001
Mailing Address - Country:US
Mailing Address - Phone:208-939-9513
Mailing Address - Fax:
Practice Address - Street 1:935 E WINDING CREEK DR
Practice Address - Street 2:SUITE 120
Practice Address - City:EAGLE
Practice Address - State:ID
Practice Address - Zip Code:83616-7240
Practice Address - Country:US
Practice Address - Phone:208-938-4748
Practice Address - Fax:208-938-1710
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-1109235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist