Provider Demographics
NPI:1619140555
Name:PLONSKER, LESLIE ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:ANN
Last Name:PLONSKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 4TH AVE
Mailing Address - Street 2:046C COLLEGE OF PROFESSIONAL STUDIES
Mailing Address - City:STEVENS POINT
Mailing Address - State:WI
Mailing Address - Zip Code:54481-1909
Mailing Address - Country:US
Mailing Address - Phone:715-346-4835
Mailing Address - Fax:715-346-2157
Practice Address - Street 1:1901 4TH AVE
Practice Address - Street 2:046C COLLEGE OF PROFESSIONAL STUDIES
Practice Address - City:STEVENS POINT
Practice Address - State:WI
Practice Address - Zip Code:54481-1909
Practice Address - Country:US
Practice Address - Phone:715-346-4835
Practice Address - Fax:715-346-2157
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI235Z00000X235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist