Provider Demographics
NPI:1518841303
Name:LECLAIR-JOHNSON, MADELYN BRYN (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:MADELYN
Middle Name:BRYN
Last Name:LECLAIR-JOHNSON
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6021 S WAKEFIELD LN APT 108
Mailing Address - Street 2:
Mailing Address - City:NEW BERLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53151-7960
Mailing Address - Country:US
Mailing Address - Phone:920-839-5242
Mailing Address - Fax:
Practice Address - Street 1:3360 GATEWAY RD STE 200
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53045-5115
Practice Address - Country:US
Practice Address - Phone:262-295-6294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist