Provider Demographics
NPI:1750722740
Name:LEONARD, LYNDI (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:LYNDI
Middle Name:
Last Name:LEONARD
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 E HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057-1632
Mailing Address - Country:US
Mailing Address - Phone:563-920-0466
Mailing Address - Fax:
Practice Address - Street 1:510 E HOWARD ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:IA
Practice Address - Zip Code:52057-1632
Practice Address - Country:US
Practice Address - Phone:563-920-0466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146011609235Z00000X
IA083500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist