Provider Demographics
NPI:1528258019
Name:MONAHAN, LEANNE (MA SLP-CCC)
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:MONAHAN
Suffix:
Gender:F
Credentials:MA SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PENN PLZ
Mailing Address - Street 2:FERREN MALL
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-2162
Mailing Address - Country:US
Mailing Address - Phone:732-342-8508
Mailing Address - Fax:732-342-8514
Practice Address - Street 1:1 PENN PLZ
Practice Address - Street 2:FERREN MALL
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2162
Practice Address - Country:US
Practice Address - Phone:732-342-8508
Practice Address - Fax:732-342-8514
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00300700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist