Individual
ELLYSE LEOPOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
2550 S STATE ROUTE 100, TIFFIN, OH 44883-9356
(419) 447-7203
Mailing address
2913 S TOWNSHIP ROAD 159, TIFFIN, OH 44883-8809
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP.11698
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0940576
—
OH
Enumeration date
08/02/2017
Last updated
08/15/2022
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