Provider Demographics
NPI:1457791162
Name:HOLCZER, LEON (MA, CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:LEON
Middle Name:
Last Name:HOLCZER
Suffix:
Gender:M
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 1:15 MONTGOMERY AVE
Mailing Address - Street 2:APT. # 7A
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-2657
Mailing Address - Country:US
Mailing Address - Phone:484-278-4363
Mailing Address - Fax:
Practice Address - Street 1:15 MONTGOMERY AVE
Practice Address - Street 2:APT. # 7A
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-2657
Practice Address - Country:US
Practice Address - Phone:484-278-4363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-26
Last Update Date:2013-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010307235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist