Provider Demographics
NPI:1679132450
Name:GARDNER, LEANNE MORGAN (AUD)
Entity Type:Individual
Prefix:DR
First Name:LEANNE
Middle Name:MORGAN
Last Name:GARDNER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:157 CORLEY MILL RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7600
Mailing Address - Country:US
Mailing Address - Phone:803-256-2483
Mailing Address - Fax:
Practice Address - Street 1:157 CORLEY MILL RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-7600
Practice Address - Country:US
Practice Address - Phone:803-256-2483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAUD4119231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAUD4119OtherLICENSE