Provider Demographics
NPI:1851788855
Name:ADIS, LEIGH (SLP)
Entity Type:Individual
Prefix:MRS
First Name:LEIGH
Middle Name:
Last Name:ADIS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6980 E SAHUARO DR
Mailing Address - Street 2:APT 1038
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-5292
Mailing Address - Country:US
Mailing Address - Phone:914-980-0191
Mailing Address - Fax:
Practice Address - Street 1:6980 E SAHUARO DR
Practice Address - Street 2:APT 1038
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-5292
Practice Address - Country:US
Practice Address - Phone:914-980-0191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ9251235Z00000X
NY58021629235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist