Provider Demographics
NPI:1003043225
Name:PALLIERE, LESLIE (MS-CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:
Last Name:PALLIERE
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 1:4316 PINEWOOD TER
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-9523
Mailing Address - Country:US
Mailing Address - Phone:914-525-3070
Mailing Address - Fax:
Practice Address - Street 1:134 INFIELD CT
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8026
Practice Address - Country:US
Practice Address - Phone:704-799-6824
Practice Address - Fax:704-799-6825
Is Sole Proprietor?:No
Enumeration Date:2009-06-15
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP 008361235Z00000X
SCSLP.5423 SLP235Z00000X
SCSLP.5423235Z00000X
UT7754734-4102235Z00000X
NY018763-1235Z00000X
NY1149660235Z00000X
GA008361235Z00000X
GASLP008361235Z00000X
UT567658235Z00000X
NC14406235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist