Provider Demographics
NPI:1073786489
Name:CALDWELL, LESLIE A (MA CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:A
Last Name:CALDWELL
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 1:336 N OVERLOOK ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-6004
Mailing Address - Country:US
Mailing Address - Phone:913-832-6673
Mailing Address - Fax:
Practice Address - Street 1:450 E PARK ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-5410
Practice Address - Country:US
Practice Address - Phone:913-324-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2481235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist