Provider Demographics
NPI:1548579774
Name:RUNYAN, LEAH ALLISON (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:ALLISON
Last Name:RUNYAN
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 1:7302 CRYSTALBROOK DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78724-3313
Mailing Address - Country:US
Mailing Address - Phone:737-333-1441
Mailing Address - Fax:512-222-4330
Practice Address - Street 1:7302 CRYSTALBROOK DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78724-3313
Practice Address - Country:US
Practice Address - Phone:737-333-1441
Practice Address - Fax:512-222-4330
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110946235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist