| NPI | 1235298415 |
|---|---|
| Former Name | HOLLY ANNE LEICHTNAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: CO 532) |
| Additional Taxonomies | 237600000X Audiologist-Hearing Aid Fitter (Licence: MN 7936) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2009-01-16 |