Provider Demographics
NPI:1609647163
Name:EDWARDS, LESLIE A (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:A
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COLE HEALTH PEDIATRIC
Mailing Address - Street 2:19241 DAVID MEMORIAL DR STE 170A, THE WOODLANDS,
Mailing Address - City:WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77385
Mailing Address - Country:US
Mailing Address - Phone:985-247-1021
Mailing Address - Fax:
Practice Address - Street 1:COLE HEALTH PEDIATRIC
Practice Address - Street 2:19241 DAVID MEMORIAL DR STE 170A, THE WOODLANDS,
Practice Address - City:WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77385
Practice Address - Country:US
Practice Address - Phone:985-247-1021
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108303235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty