Basic Information
| Provider Information | |||||||||
| NPI: | 1851968937 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LECROY | ||||||||
| FirstName: | LEAH | ||||||||
| MiddleName: | LANELL | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MS CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6995 SHADY OAKS LN | ||||||||
| Address2: | |||||||||
| City: | TRUSSVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 351735221 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2055681809 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 315 6TH ST S | ||||||||
| Address2: | |||||||||
| City: | ONEONTA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 351211828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2052742244 | ||||||||
| FaxNumber: | 2052742245 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/08/2021 | ||||||||
| LastUpdateDate: | 06/08/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 4920 | AL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.