Provider Demographics
NPI:1467686337
Name:TOLBERT, LESLIE CAROL (PHD)
Entity Type:Individual
Prefix:PROF
First Name:LESLIE
Middle Name:CAROL
Last Name:TOLBERT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1888 RIZZO DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89434-3444
Mailing Address - Country:US
Mailing Address - Phone:775-302-6219
Mailing Address - Fax:
Practice Address - Street 1:1888 RIZZO DR
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89434-3444
Practice Address - Country:US
Practice Address - Phone:775-302-6219
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-07
Last Update Date:2009-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP533235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist