Provider Demographics
NPI:1770796864
Name:HINE, LEAH S (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:S
Last Name:HINE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13658 OCONNOR RD.
Mailing Address - Street 2:APT. 808
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233
Mailing Address - Country:US
Mailing Address - Phone:210-362-4038
Mailing Address - Fax:
Practice Address - Street 1:700 N. COLORADO BLVD
Practice Address - Street 2:#318
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206
Practice Address - Country:US
Practice Address - Phone:866-801-9492
Practice Address - Fax:866-293-4719
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103007235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist