Provider Demographics
NPI:1922677228
Name:LEUSCHKE, SYDNEY NICOLE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SYDNEY
Middle Name:NICOLE
Last Name:LEUSCHKE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16002 2ND STREET E
Mailing Address - Street 2:
Mailing Address - City:REDINGTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33708
Mailing Address - Country:US
Mailing Address - Phone:815-973-9411
Mailing Address - Fax:
Practice Address - Street 1:16002 2ND STREET E
Practice Address - Street 2:
Practice Address - City:REDINGTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33708
Practice Address - Country:US
Practice Address - Phone:815-973-9411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-21
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist