Provider Demographics
NPI:1649843863
Name:LEONARD, LARA (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:LARA
Middle Name:
Last Name:LEONARD
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80209-4024
Mailing Address - Country:US
Mailing Address - Phone:314-495-1631
Mailing Address - Fax:
Practice Address - Street 1:14415 E SMOKY HILL RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1238
Practice Address - Country:US
Practice Address - Phone:720-524-7648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-24
Last Update Date:2021-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist