Provider Demographics
NPI:1366969354
Name:LEITNAKER, LEAH ABBIGAIL (MS, CF-SLP)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:ABBIGAIL
Last Name:LEITNAKER
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 SKYLINE DR APT 9
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-3780
Mailing Address - Country:US
Mailing Address - Phone:423-612-1468
Mailing Address - Fax:
Practice Address - Street 1:525 W OAKLAND AVE STE 205
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-1673
Practice Address - Country:US
Practice Address - Phone:423-281-7002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-29
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6173235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist