Provider Demographics
NPI:1982721015
Name:NEWCOMB, LESLEY ANN (MACCC-SLP)
Entity type:Individual
Prefix:MS
First Name:LESLEY
Middle Name:ANN
Last Name:NEWCOMB
Suffix:
Gender:F
Credentials:MACCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 BRENT CT
Mailing Address - Street 2:
Mailing Address - City:THOROFARE
Mailing Address - State:NJ
Mailing Address - Zip Code:08086-2001
Mailing Address - Country:US
Mailing Address - Phone:856-313-7424
Mailing Address - Fax:
Practice Address - Street 1:116 BRENT CT
Practice Address - Street 2:
Practice Address - City:THOROFARE
Practice Address - State:NJ
Practice Address - Zip Code:08086-2001
Practice Address - Country:US
Practice Address - Phone:856-313-7424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00488200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist