Provider Demographics
NPI:1861149767
Name:LEIGHTON, JENNIFER A (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:A
Last Name:LEIGHTON
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 1:2B MCDERMOTT FARM RD
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3566
Mailing Address - Country:US
Mailing Address - Phone:617-270-3297
Mailing Address - Fax:
Practice Address - Street 1:2B MCDERMOTT FARM RD
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3566
Practice Address - Country:US
Practice Address - Phone:617-270-3297
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-10
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2989235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty