Provider Demographics
NPI:1710541685
Name:LEIGH ANN SLP, LLC
Entity Type:Organization
Organization Name:LEIGH ANN SLP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:THORNSBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC/SLP
Authorized Official - Phone:606-626-0010
Mailing Address - Street 1:1031 KY ROUTE 306
Mailing Address - Street 2:
Mailing Address - City:WHEELWRIGHT
Mailing Address - State:KY
Mailing Address - Zip Code:41669-9031
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1031 KY ROUTE 306
Practice Address - Street 2:
Practice Address - City:WHEELWRIGHT
Practice Address - State:KY
Practice Address - Zip Code:41669-9031
Practice Address - Country:US
Practice Address - Phone:606-626-0010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-26
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency