Provider Demographics
NPI:1437448677
Name:BUSH, LESLIE D (LHS)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:D
Last Name:BUSH
Suffix:
Gender:F
Credentials:LHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13009 SPRING HILL DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-5048
Mailing Address - Country:US
Mailing Address - Phone:352-556-5257
Mailing Address - Fax:
Practice Address - Street 1:13009 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-5048
Practice Address - Country:US
Practice Address - Phone:352-556-5257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS4384237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist