Provider Demographics
NPI:1972782233
Name:KALOWSKY, LEORA BEACCO (MED CCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:LEORA
Middle Name:BEACCO
Last Name:KALOWSKY
Suffix:
Gender:F
Credentials:MED CCCSLP
Other - Prefix:MS
Other - First Name:LEORA
Other - Middle Name:ANN
Other - Last Name:BEACCO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED CCCSLP
Mailing Address - Street 1:92 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:SUGARLOAF
Mailing Address - State:PA
Mailing Address - Zip Code:18249
Mailing Address - Country:US
Mailing Address - Phone:570-788-3502
Mailing Address - Fax:570-788-7311
Practice Address - Street 1:92 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:SUGARLOAF
Practice Address - State:PA
Practice Address - Zip Code:18249
Practice Address - Country:US
Practice Address - Phone:570-788-3502
Practice Address - Fax:570-788-7311
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL001930L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist