Provider Demographics
NPI:1902051725
Name:MCLEAN, KRISTIN LEIGH (SLP)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:LEIGH
Last Name:MCLEAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 MISTY MDW
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-5405
Mailing Address - Country:US
Mailing Address - Phone:215-453-0795
Mailing Address - Fax:
Practice Address - Street 1:102 MISTY MDW
Practice Address - Street 2:
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-5405
Practice Address - Country:US
Practice Address - Phone:215-453-0795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL005420L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist