Provider Demographics
NPI:1154989747
Name:LEACH, AMBER DENISE (HEARING SPECIALIST L)
Entity type:Individual
Prefix:MS
First Name:AMBER
Middle Name:DENISE
Last Name:LEACH
Suffix:
Gender:M
Credentials:HEARING SPECIALIST L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4405 KUKEI GROVE ST SUITE 101
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766
Mailing Address - Country:US
Mailing Address - Phone:806-651-8677
Mailing Address - Fax:806-246-6160
Practice Address - Street 1:4405 KUKEI GROVE ST SUITE 101
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766
Practice Address - Country:US
Practice Address - Phone:806-651-8677
Practice Address - Fax:806-246-6160
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHA114237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist