Provider Demographics
NPI:1619208014
Name:LESLIE, SHERRI L (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:L
Last Name:LESLIE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28711 W OAKLAND RD
Mailing Address - Street 2:
Mailing Address - City:BAY VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44140-2042
Mailing Address - Country:US
Mailing Address - Phone:440-835-4961
Mailing Address - Fax:
Practice Address - Street 1:3430 ROCKY RIVER DR
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-2954
Practice Address - Country:US
Practice Address - Phone:440-227-8664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-25
Last Update Date:2010-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-8019235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist