Provider Demographics
NPI:1932308434
Name:MCCOWAN, LESLIE (MS CCCA)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:MCCOWAN
Suffix:
Gender:F
Credentials:MS CCCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 CENTRAL STREET
Mailing Address - Street 2:THE LEARNING CENTER FOR DEAF CHILDREN
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701
Mailing Address - Country:US
Mailing Address - Phone:508-875-4559
Mailing Address - Fax:508-875-9203
Practice Address - Street 1:848 CENTRAL STREET
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701
Practice Address - Country:US
Practice Address - Phone:508-875-4559
Practice Address - Fax:508-875-9203
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA139231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA602455OtherHARVARD PILGRIM HEALTH C
MA468899OtherTUFTS HEALTH PLAN
MAAD0044OtherBLUE CROSS BLUE SHIELD
MA1301713Medicaid