Provider Demographics
NPI:1508322140
Name:SOUTHERN NEVADA SPEECH AND LANGUAGE SERVICES
Entity Type:Organization
Organization Name:SOUTHERN NEVADA SPEECH AND LANGUAGE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIESLER
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:702-670-0264
Mailing Address - Street 1:7582 LAS VEGAS BLVD S STE 143
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-1009
Mailing Address - Country:US
Mailing Address - Phone:702-670-0264
Mailing Address - Fax:
Practice Address - Street 1:7582 LAS VEGAS BLVD S STE 143
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-1009
Practice Address - Country:US
Practice Address - Phone:702-670-0264
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1548799034Medicaid