Provider Demographics
NPI:1568654036
Name:MURRIETA, LEIGH (MED, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:
Last Name:MURRIETA
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11111 HOUZE ROAD, SUITE 101
Mailing Address - Street 2:COBBLESTONE THERAPY GROUP
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076
Mailing Address - Country:US
Mailing Address - Phone:770-998-9599
Mailing Address - Fax:
Practice Address - Street 1:11111 HOUZE RD STE 101
Practice Address - Street 2:COBBLESTONE THERAPY GROUP
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1464
Practice Address - Country:US
Practice Address - Phone:770-998-9599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP0004859235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist