Provider Demographics
NPI:1962673616
Name:TREADWAY, ELENA LEBLANC (AUD, CCC-A)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:LEBLANC
Last Name:TREADWAY
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:CRISTINA
Other - Last Name:LEBLANC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-A
Mailing Address - Street 1:2615 NORTH DRIVE
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70510
Mailing Address - Country:US
Mailing Address - Phone:337-898-3700
Mailing Address - Fax:337-898-3702
Practice Address - Street 1:2615 NORTH DRIVE
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70510
Practice Address - Country:US
Practice Address - Phone:337-898-3700
Practice Address - Fax:337-898-3702
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-20
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4757231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist