Provider Demographics
NPI:1962639625
Name:MICHAELS, LEIGH (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:
Last Name:MICHAELS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:
Other - Last Name:PERRINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 S LEE HWY
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TN
Mailing Address - Zip Code:37311-5853
Mailing Address - Country:US
Mailing Address - Phone:423-476-0620
Mailing Address - Fax:423-476-0485
Practice Address - Street 1:800 S LEE HWY
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TN
Practice Address - Zip Code:37311-5853
Practice Address - Country:US
Practice Address - Phone:423-476-0620
Practice Address - Fax:423-476-0485
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3940235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist