Provider Demographics
NPI:1689850679
Name:LEIZER, AMY ANN (MA CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:ANN
Last Name:LEIZER
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
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Mailing Address - Street 1:227 SW ALBATROSS CT
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64082-4501
Mailing Address - Country:US
Mailing Address - Phone:816-892-1352
Mailing Address - Fax:816-892-1384
Practice Address - Street 1:21005 S SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PECULIAR
Practice Address - State:MO
Practice Address - Zip Code:64078-9346
Practice Address - Country:US
Practice Address - Phone:816-892-1352
Practice Address - Fax:816-892-1384
Is Sole Proprietor?:No
Enumeration Date:2008-01-21
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005002752235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist