Provider Demographics
NPI:1497649420
Name:LEONARD, ANDREA LYNN (CCC-SLP, MEA)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:LYNN
Last Name:LEONARD
Suffix:
Gender:F
Credentials:CCC-SLP, MEA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:GODFREY
Mailing Address - State:IL
Mailing Address - Zip Code:62035-5607
Mailing Address - Country:US
Mailing Address - Phone:618-616-9078
Mailing Address - Fax:
Practice Address - Street 1:1911 PRIMROSE LN
Practice Address - Street 2:
Practice Address - City:GODFREY
Practice Address - State:IL
Practice Address - Zip Code:62035-5607
Practice Address - Country:US
Practice Address - Phone:618-616-9078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist