Provider Demographics
NPI:1962671727
Name:COLBERT, LEIGH ANNE (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LEIGH ANNE
Middle Name:
Last Name:COLBERT
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3304 168TH PL SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-5752
Mailing Address - Country:US
Mailing Address - Phone:425-443-6824
Mailing Address - Fax:
Practice Address - Street 1:3707 PROVIDENCE POINT DR SE
Practice Address - Street 2:SUITE C
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029-6216
Practice Address - Country:US
Practice Address - Phone:425-557-6657
Practice Address - Fax:425-557-4409
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-26
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00004142235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist