Provider Demographics
NPI:1295037455
Name:LEIGHTON, ELYCE JANET (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ELYCE
Middle Name:JANET
Last Name:LEIGHTON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1038 OLYMPIA RD
Mailing Address - Street 2:
Mailing Address - City:NORTH BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-1937
Mailing Address - Country:US
Mailing Address - Phone:516-680-7532
Mailing Address - Fax:
Practice Address - Street 1:11801 101ST AVE
Practice Address - Street 2:
Practice Address - City:SOUTH RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11419-1229
Practice Address - Country:US
Practice Address - Phone:718-805-7117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-21
Last Update Date:2010-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019723235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist