Provider Demographics
NPI:1124273271
Name:MANN, LEIGH ANNE CARRICO (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:LEIGH
Middle Name:ANNE CARRICO
Last Name:MANN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:ANNE
Other - Last Name:CARRICO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:128 PURDY ST
Mailing Address - Street 2:
Mailing Address - City:HIGHTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-3614
Mailing Address - Country:US
Mailing Address - Phone:502-548-3909
Mailing Address - Fax:
Practice Address - Street 1:128 PURDY ST
Practice Address - Street 2:
Practice Address - City:HIGHTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08520-3614
Practice Address - Country:US
Practice Address - Phone:502-548-3909
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-17
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018436-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist