Provider Demographics
NPI:1396594925
Name:LEAL, PATRICIA FONTES
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:FONTES
Last Name:LEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87-1110 OHEOHE ST
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-3456
Mailing Address - Country:US
Mailing Address - Phone:714-425-9067
Mailing Address - Fax:
Practice Address - Street 1:725 KAPIOLANI BLVD STE C206
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-6024
Practice Address - Country:US
Practice Address - Phone:808-596-0099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty