Basic Information
Provider Information
NPI: 1174675805
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SEIFERT
FirstName: LEAH
MiddleName: MARIE-COX
NamePrefix:  
NameSuffix:  
Credential: SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: COX
OtherFirstName: LEAH
OtherMiddleName: MARIE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: SLP
OtherLastNameType: 1
Mailing Information
Address1: 1095 HIGHWAY 15 S
Address2:  
City: HUTCHINSON
State: MN
PostalCode: 553505000
CountryCode: US
TelephoneNumber: 3202345000
FaxNumber:  
Practice Location
Address1: 1095 HIGHWAY 15 S
Address2:  
City: HUTCHINSON
State: MN
PostalCode: 553505000
CountryCode: US
TelephoneNumber: 3202345000
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/16/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X6159MNY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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