Provider Demographics
NPI:1841414083
Name:VLCEK, LESLIE SUZANNE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:SUZANNE
Last Name:VLCEK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:SUZANNE
Other - Last Name:URSU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:5713 PHILLIPS RE
Mailing Address - Street 2:
Mailing Address - City:GIBSONIA
Mailing Address - State:PA
Mailing Address - Zip Code:15044-9323
Mailing Address - Country:US
Mailing Address - Phone:724-355-8062
Mailing Address - Fax:
Practice Address - Street 1:5465 WILLIAM FLYNN HWY
Practice Address - Street 2:
Practice Address - City:GIBSONIA
Practice Address - State:PA
Practice Address - Zip Code:15044-9696
Practice Address - Country:US
Practice Address - Phone:724-444-5333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL006471L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist