Provider Demographics
NPI:1164951240
Name:KOHL, LEAH DANIELLE (MS CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:LEAH
Middle Name:DANIELLE
Last Name:KOHL
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MRS
Other - First Name:LEAH
Other - Middle Name:DANIELLE
Other - Last Name:DERAOUI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:24600 SILVER CLOUD CT STE 104
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-6555
Mailing Address - Country:US
Mailing Address - Phone:302-690-4644
Mailing Address - Fax:
Practice Address - Street 1:24600 SILVER CLOUD CT STE 104
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-6555
Practice Address - Country:US
Practice Address - Phone:302-690-4644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-12
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA30239235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist