MEDICARE: ABIGAIL LEPOSA CCC-SLP, CLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist		PA

General Provider Information

NPI Number	:	1265260616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABIGAIL LEPOSA CCC-SLP, CLC

Provider Business Mailing Address
First Line	:	134 PLEASANT ST
Second Line	:
City	:	BRADFORD
State	:	PA
Zip	:	16701-1152
Country	:	US
Telephone Number	:	814-596-3581
Fax Number	:

Provider Business Practice Location Address
First Line	:	4108 MAIN ST
Second Line	:
City	:	ERIE
State	:	PA
Zip	:	16511-1968
Country	:	US
Telephone Number	:	814-813-2759
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2024
Last Update Date	:	07/25/2024

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