Leanne Elizabeth Bulla – Speech-Language Pathologist

Key facts

NPI: 1477993418
Entity type: Individual (NPI type 1)
Primary specialty: Speech-Language Pathologist 235Z00000X
License: 05774 (MD)
Practice address: 3090 N Academy Blvd
Colorado Springs, CO 80917-5310
Phone: (719) 574-8300
Fax: (719) 574-9547
NPI assigned: Jul 3, 2013
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Master of Science

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Speech-Language Pathologist	235Z00000X	05774	MD	Yes

Addresses

Primary practice location

3090 N Academy Blvd
Colorado Springs, CO 80917-5310

Mailing address

3090 N Academy Blvd
Colorado Springs, CO 80917-5310
Phone (719) 574-8300

Other names

Leanne Elizabeth Moran Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 3, 2013.

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372809600000",
    "number": "1477993418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3090 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175310",
            "telephone_number": "719-574-8300",
            "fax_number": "719-574-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3090 N ACADEMY BLVD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175310",
            "telephone_number": "719-574-8300",
            "fax_number": "719-574-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLA",
        "first_name": "LEANNE",
        "middle_name": "ELIZABETH",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2013-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "05774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEANNE",
            "last_name": "MORAN",
            "middle_name": "ELIZABETH",
            "credential": "M.S., CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Colorado Springs, CO

All providers in Colorado Springs, CO · Speech-Language Pathologist in Colorado

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 3, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.