Provider Demographics
NPI:1013770593
Name:L'ECLUSE, TONI (SLP)
Entity Type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:L'ECLUSE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14136 STONEY GATE PL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-4252
Mailing Address - Country:US
Mailing Address - Phone:619-300-1029
Mailing Address - Fax:
Practice Address - Street 1:14136 STONEY GATE PL
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-4252
Practice Address - Country:US
Practice Address - Phone:619-300-1029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13009235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist