Provider Demographics
NPI:1114051265
Name:GODSEY, LESLIE ANN (MS)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:ANN
Last Name:GODSEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 ABINGDON BEACH RD
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:MD
Mailing Address - Zip Code:21009-1333
Mailing Address - Country:US
Mailing Address - Phone:410-893-6622
Mailing Address - Fax:
Practice Address - Street 1:139 N MAIN ST
Practice Address - Street 2:STE 306
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-8843
Practice Address - Country:US
Practice Address - Phone:410-893-6622
Practice Address - Fax:410-282-3651
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00507231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4500029OtherUNITED HEALTHCARE
MDL099OtherCAREFIRST BC BS
MD557733OtherAETNA
MDE386OtherCAREFIRST BLUECHOICE
MDL099OtherCAREFIRST BC BS
MDE386OtherCAREFIRST BLUECHOICE