Provider Demographics
NPI:1265490361
Name:THEYS, LESLIE ANN (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:ANN
Last Name:THEYS
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:A
Other - Last Name:HICKCOX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSCCCSLP
Mailing Address - Street 1:635 LITTLE HORSE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:NEWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28657-9276
Mailing Address - Country:US
Mailing Address - Phone:919-915-1893
Mailing Address - Fax:866-432-6140
Practice Address - Street 1:635 LITTLE HORSE CREEK RD
Practice Address - Street 2:
Practice Address - City:NEWLAND
Practice Address - State:NC
Practice Address - Zip Code:28657-9276
Practice Address - Country:US
Practice Address - Phone:919-915-1893
Practice Address - Fax:866-432-6140
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8539235Z00000X
NCNC8539235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7413265Medicaid
WI1171-154OtherSPEECH AND LANGUAGE LICEN
NC8539OtherNC LICENSE