Provider Demographics
NPI:1154548709
Name:ONGLEY, LEENA M (MED CCC A SLP)
Entity type:Individual
Prefix:
First Name:LEENA
Middle Name:M
Last Name:ONGLEY
Suffix:
Gender:F
Credentials:MED CCC A SLP
Other - Prefix:
Other - First Name:LEENA
Other - Middle Name:M
Other - Last Name:HEINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-A SLP
Mailing Address - Street 1:5201 E NORTHERN LIGHTS BLVD
Mailing Address - Street 2:UNIT 6
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4776
Mailing Address - Country:US
Mailing Address - Phone:907-301-4272
Mailing Address - Fax:907-729-1094
Practice Address - Street 1:5201 E NORTHERN LIGHTS BLVD
Practice Address - Street 2:UNIT 6-W
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4776
Practice Address - Country:US
Practice Address - Phone:907-301-4272
Practice Address - Fax:907-301-4272
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKA 35231H00000X
AKS 49235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKSP78042Medicaid
AKAU78042Medicaid