Provider Demographics
NPI:1821773151
Name:LEBLANC, NELL H (MS SLP)
Entity type:Individual
Prefix:
First Name:NELL
Middle Name:H
Last Name:LEBLANC
Suffix:
Gender:
Credentials:MS SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 N FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-4304
Mailing Address - Country:US
Mailing Address - Phone:516-426-3891
Mailing Address - Fax:
Practice Address - Street 1:264 BEACH 19TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4431
Practice Address - Country:US
Practice Address - Phone:718-868-2961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
NY034455235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist