Provider Demographics
NPI:1164555447
Name:FLETCHER, LEANNE O'NEIL (AUD)
Entity Type:Individual
Prefix:DR
First Name:LEANNE
Middle Name:O'NEIL
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 FALMOUTH RD
Mailing Address - Street 2:
Mailing Address - City:MASHPEE
Mailing Address - State:MA
Mailing Address - Zip Code:02649-3303
Mailing Address - Country:US
Mailing Address - Phone:508-539-9780
Mailing Address - Fax:508-539-9830
Practice Address - Street 1:800 FALMOUTH RD
Practice Address - Street 2:
Practice Address - City:MASHPEE
Practice Address - State:MA
Practice Address - Zip Code:02649-3303
Practice Address - Country:US
Practice Address - Phone:508-539-9780
Practice Address - Fax:508-539-9830
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA543237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA012164Medicare ID - Type Unspecified