Provider Demographics
NPI:1861281875
Name:GORELIK, LEEZA NICOLE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:LEEZA
Middle Name:NICOLE
Last Name:GORELIK
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6235 BECK AVE APT 308
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-5805
Mailing Address - Country:US
Mailing Address - Phone:209-640-4609
Mailing Address - Fax:
Practice Address - Street 1:6235 BECK AVE APT 308
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-5805
Practice Address - Country:US
Practice Address - Phone:323-899-6363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14420907235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist