Provider Demographics
NPI:1063730422
Name:LEONE, BETSY ANN (MS CCC-SLP, BCBA)
Entity type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:ANN
Last Name:LEONE
Suffix:
Gender:F
Credentials:MS CCC-SLP, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5257 WENTZ RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21102-1221
Mailing Address - Country:US
Mailing Address - Phone:716-680-0831
Mailing Address - Fax:
Practice Address - Street 1:11500 CRONRIDGE DR
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-1434
Practice Address - Country:US
Practice Address - Phone:410-517-1113
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-11
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NY019985235Z00000X
MD06850235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst