Healthcare Provider Details

I. General information

NPI: 1578643029
Provider Name (Legal Business Name): LEADER SPEECH AND HEARING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 06/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 SCOTLAND RD BROWN HUMAN SERVICES BLDG. - 2ND FLOOR
EDINBORO PA
16444-0001
US

IV. Provider business mailing address

215 SCOTLAND RD BROWN HUMAN SERVICES BLDG. - 2ND FLOOR
EDINBORO PA
16444-0001
US

V. Phone/Fax

Practice location:
  • Phone: 814-732-2433
  • Fax: 814-732-2612
Mailing address:
  • Phone: 814-732-2433
  • Fax: 814-732-2612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. CYNTHIA REYES-PABON
Title or Position: CLINIC DIRECTOR
Credential: M S CCC SLP
Phone: 814-732-2433