Provider Demographics
NPI:1457712127
Name:MCLAUGHLIN, LESLIE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:
Other - Last Name:LESSARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:400 FLANDERS RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2816
Mailing Address - Country:US
Mailing Address - Phone:860-628-4283
Mailing Address - Fax:
Practice Address - Street 1:400 FLANDERS RD
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489
Practice Address - Country:US
Practice Address - Phone:860-628-4283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-09
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT4264363AM0700X
CT4716235Z00000X
IL146013060235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical