Individual
MRS. LESLIE K HEINEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
30 HUNTER DR, MUNCY, PA 17756-7682
(570) 971-0182
Mailing address
30 HUNTER DR, MUNCY, PA 17756-7682
(570) 971-0182
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL006336L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1019257950001
—
PA
Enumeration date
07/18/2007
Last updated
07/18/2007
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