Provider Demographics
NPI:1487804332
Name:MACMILLAN, LEAH (MS, CCC/SLP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:MACMILLAN
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MANNING DR
Mailing Address - Street 2:G0303 NEUROSCIENCES, DEPT OF SPEECH AND AUDIOLOGY
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-4220
Mailing Address - Country:US
Mailing Address - Phone:919-966-8047
Mailing Address - Fax:919-843-3280
Practice Address - Street 1:101 MANNING DR
Practice Address - Street 2:G0303 NEUROSCIENCES, DEPT OF AUDIOLOGY AND SPEECH PATH
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-4220
Practice Address - Country:US
Practice Address - Phone:919-843-0425
Practice Address - Fax:919-966-8690
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7035235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist