Provider Demographics
NPI:1952507733
Name:MURRAY LEETY, TAMARA M (MS)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:M
Last Name:MURRAY LEETY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 RICHMONT ST
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18509-1503
Mailing Address - Country:US
Mailing Address - Phone:570-343-4646
Mailing Address - Fax:
Practice Address - Street 1:1205 RICHMONT ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18509-1503
Practice Address - Country:US
Practice Address - Phone:570-343-4646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007247235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist