Provider Demographics
NPI:1235948589
Name:LEONARD, JULIE MARIE (HIS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:MARIE
Last Name:LEONARD
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 COLLINGWOOD ST NE
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-3721
Mailing Address - Country:US
Mailing Address - Phone:856-745-5537
Mailing Address - Fax:
Practice Address - Street 1:100 ARBOR DR STE 111
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073-6585
Practice Address - Country:US
Practice Address - Phone:540-381-4327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2101002808237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist