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SAMANTHA LEYSE

>> Speech-Language Pathologist >> Speech, Language and Hearing Service Providers

Registrant NPI Number: 1356703391

Individual Registrant:
 SAMANTHA  LEYSE 
Gender: F
Not Sole Proprietor

Location and contact information for practice:
200 PERRY HOUSE RD  FITZGERALD, GA 31750-8857 US
Tel: 229-424-7104  Fax: 229-424-7122

Contact information for business:
200 PERRY HOUSE RD P O BOX 1447 FITZGERALD, GA 31750-8857 US
Tel: 229-424-7104  Fax: 229-424-7122

Registration Information:
NPI: 1356703391
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y235Z00000XSpeech, Language and Hearing Service Providers
Speech-Language Pathologist
GAPCET002247

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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