Lara Leedom
Speech-Language Pathologist, in Dallas, TX. Individual provider (NPI-1).
NPI number1962059360
StatusActive
Last updated in NPPESAug 20, 2019
Details
- NPI
- 1962059360
- Entity type
- Individual (NPI-1)
- Name
- Lara Leedom
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 20, 2019
- Last updated
- Aug 20, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 235Z00000X | Speech-Language Pathologist, | 115639 | TX | Yes |
Practice location
3939 Briargrove Ln Apt 6101Dallas, TX 75287-6354
Phone 318-210-7370
Mailing address
3939 Briargrove Ln Apt 6101Dallas, TX 75287-6354
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