Provider Demographics
NPI:1093362436
Name:SCANLON, LEAH (MS,CCC-SLP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:SCANLON
Suffix:
Gender:
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:DOHERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CCC-SLP
Mailing Address - Street 1:158 BRYANT ST NW APT 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-7018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:158 BRYANT ST NW APT 2
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-7018
Practice Address - Country:US
Practice Address - Phone:732-299-7144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-21
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCSLP001238OtherDC HEALTH
MD08482OtherMARYLAND DEPARTMENT OF HEALTH