Provider Demographics
NPI:1740360692
Name:LESNIAK, DENNIS PAUL (MA, CCC/A)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:PAUL
Last Name:LESNIAK
Suffix:
Gender:M
Credentials:MA, CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 SEVERANCE CIR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-1533
Mailing Address - Country:US
Mailing Address - Phone:216-297-2651
Mailing Address - Fax:216-297-2658
Practice Address - Street 1:10 SEVERANCE CIR
Practice Address - Street 2:
Practice Address - City:CLEVELAND HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-1533
Practice Address - Country:US
Practice Address - Phone:216-297-2651
Practice Address - Fax:216-297-2658
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA 00393231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0014611OtherBCMH
OH4122761Medicare ID - Type Unspecified