Provider Demographics
NPI:1427829969
Name:LEAP LANGUAGE AND DEVELOPMENTAL SERVICES
Entity type:Organization
Organization Name:LEAP LANGUAGE AND DEVELOPMENTAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:LOCKARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-482-3324
Mailing Address - Street 1:150 SUMMERFIELD DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-4833
Mailing Address - Country:US
Mailing Address - Phone:770-329-9165
Mailing Address - Fax:
Practice Address - Street 1:200 COX RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-1061
Practice Address - Country:US
Practice Address - Phone:404-482-3324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty