Provider Demographics
NPI:1730333717
Name:CHALUISANT, LEONA DEE (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LEONA
Middle Name:DEE
Last Name:CHALUISANT
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 DICKINSON AVE
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-1714
Mailing Address - Country:US
Mailing Address - Phone:607-217-5220
Mailing Address - Fax:
Practice Address - Street 1:12 DICKINSON AVE
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-1714
Practice Address - Country:US
Practice Address - Phone:607-217-5220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005124-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist