Provider Demographics
NPI:1518332675
Name:WOOD, LESLEE (HIS)
Entity Type:Individual
Prefix:MRS
First Name:LESLEE
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 331
Mailing Address - Street 2:
Mailing Address - City:RED OAK
Mailing Address - State:NC
Mailing Address - Zip Code:27868-0331
Mailing Address - Country:US
Mailing Address - Phone:252-937-6669
Mailing Address - Fax:
Practice Address - Street 1:400 BECKER DR STE A
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-3165
Practice Address - Country:US
Practice Address - Phone:252-537-0164
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1448237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist