Provider Demographics
NPI:1962658070
Name:BLUM, LEAH F (MA, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:F
Last Name:BLUM
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 SUMMERSHADE CT
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1678
Mailing Address - Country:US
Mailing Address - Phone:716-481-2157
Mailing Address - Fax:716-741-3270
Practice Address - Street 1:84 SUMMERSHADE CT
Practice Address - Street 2:
Practice Address - City:EAST AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14051-1678
Practice Address - Country:US
Practice Address - Phone:716-481-2157
Practice Address - Fax:716-741-3270
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-09
Last Update Date:2008-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008250235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist