Provider Demographics
NPI:1255933750
Name:LEPRE, MADELINE (SLP)
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:
Last Name:LEPRE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:MADELINE
Other - Middle Name:
Other - Last Name:SHARATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1404 SWEET HOME RD STE 9
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-2778
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1404 SWEET HOME RD STE 9
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-2778
Practice Address - Country:US
Practice Address - Phone:716-812-8855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11969121-4104235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist