Provider Demographics
NPI:1124434923
Name:ROOP, LEAH MICHELLE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:MICHELLE
Last Name:ROOP
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 1:15809 FEENY CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-8882
Mailing Address - Country:US
Mailing Address - Phone:704-231-8548
Mailing Address - Fax:
Practice Address - Street 1:4301 50TH ST NW STE 102
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-4394
Practice Address - Country:US
Practice Address - Phone:202-766-0126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11309235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist