Provider Demographics
NPI:1184930711
Name:SINCLAIR, LEONA (MS,CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:LEONA
Middle Name:
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 ACADEMY CIR
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976
Mailing Address - Country:US
Mailing Address - Phone:207-474-3339
Mailing Address - Fax:207-474-9558
Practice Address - Street 1:155 ACADEMY CIR
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-5113
Practice Address - Country:US
Practice Address - Phone:207-474-3339
Practice Address - Fax:207-474-9558
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP215235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist