Provider Demographics
NPI:1043418015
Name:CRABTREE, LESLIE D (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:D
Last Name:CRABTREE
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 1:5044 S LAS MANANITAS TRL
Mailing Address - Street 2:
Mailing Address - City:GOLD CANYON
Mailing Address - State:AZ
Mailing Address - Zip Code:85118-1847
Mailing Address - Country:US
Mailing Address - Phone:208-731-0319
Mailing Address - Fax:
Practice Address - Street 1:5044 S LAS MANANITAS TRL
Practice Address - Street 2:
Practice Address - City:GOLD CANYON
Practice Address - State:AZ
Practice Address - Zip Code:85118-1847
Practice Address - Country:US
Practice Address - Phone:208-731-0319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-1209235Z00000X
AZSLP10045235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist