Leasonna Olivia Boozer, M.A.
Individual provider Active NPI Speech-Language Pathologist · Selma, TX
NPI 1821114935 · NPPES record last updated Mar 13, 2020
Key facts
- NPI
- 1821114935
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 105498 (TX)
- Practice address
- 15314 Albrecht LN
Selma, TX 78154-1849 - Phone
- (864) 706-9273
- NPI assigned
- Mar 21, 2007
- 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)
- Yes
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105498 | TX | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 105498 | TX | Yes |
Addresses
Primary practice location
15314 Albrecht LN
Selma, TX 78154-1849
Mailing address
15314 Albrecht LN
Selma, TX 78154-1849
Phone (210) 890-8999
Other providers in Selma, TX
- Aus-Med Transportation
- Terri Lynne Balmos
- Elizabeth Barcelona
- Andrew C. Bennett
- BHS Physicians Network, Inc
- Jamie Lee Boubel
- Thomas Lee Brewer
- Alisa A. Brzek
- Miranda Leigh Castillo
- Chanda Holmes PLLC
All providers in Selma, TX · Speech-Language Pathologist in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2020. 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.