Provider Demographics
NPI:1104241967
Name:CHRISTIAN, LEANNE (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:
Last Name:CHRISTIAN
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 1:48 LENOX RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-5521
Mailing Address - Country:US
Mailing Address - Phone:973-706-7207
Mailing Address - Fax:
Practice Address - Street 1:48 LENOX RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-5521
Practice Address - Country:US
Practice Address - Phone:973-706-7207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-03
Last Update Date:2014-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJYS00288500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist