Provider Demographics
NPI:1144756263
Name:WILLIAMS, LESLIE EVE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:EVE
Last Name:WILLIAMS
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 1:93 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANCONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03580-4801
Mailing Address - Country:US
Mailing Address - Phone:603-823-5502
Mailing Address - Fax:
Practice Address - Street 1:747 15TH ST
Practice Address - Street 2:
Practice Address - City:POMEROY
Practice Address - State:WA
Practice Address - Zip Code:99347-9780
Practice Address - Country:US
Practice Address - Phone:509-254-3243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDSLP-3299235Z00000X
NHEL04435235Z00000X
AZSLP12542235Z00000X
WA60753055235Z00000X
NC12347235Z00000X
OR016175235Z00000X
UT11832863-4102235Z00000X
NH2048235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist