Provider Demographics
NPI:1902072713
Name:LEAHY, PATRICIA (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:LEAHY
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:PO BOX 2751
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-0751
Mailing Address - Country:US
Mailing Address - Phone:712-274-8665
Mailing Address - Fax:
Practice Address - Street 1:414 E CLARK ST
Practice Address - Street 2:USD - DEPT. OF COMMUNICATION DISORDERS
Practice Address - City:VERMILLION
Practice Address - State:SD
Practice Address - Zip Code:57069-2307
Practice Address - Country:US
Practice Address - Phone:605-677-6655
Practice Address - Fax:605-677-5767
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01586235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist