Provider Demographics
NPI:1881362523
Name:DEMKO, LEAH (AUD)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:DEMKO
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-2512
Mailing Address - Country:US
Mailing Address - Phone:614-634-1923
Mailing Address - Fax:
Practice Address - Street 1:30055 NORTHWESTERN HWY STE 101
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-3260
Practice Address - Country:US
Practice Address - Phone:248-865-4166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601001043231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist