Provider Demographics
NPI:1053570986
Name:ABRAMS, LEAH GARNER (SLP)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:GARNER
Last Name:ABRAMS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 YELLOW JACKET DR
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-3736
Mailing Address - Country:US
Mailing Address - Phone:662-574-2634
Mailing Address - Fax:662-338-5439
Practice Address - Street 1:610 YELLOW JACKET DR
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-3736
Practice Address - Country:US
Practice Address - Phone:662-574-2634
Practice Address - Fax:662-338-5439
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS2542235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSS2542OtherMS STATE BOARD OF HEALTH