Provider Demographics
NPI:1629222575
Name:ZIMCOSKY, LESLIE KATHERINE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:KATHERINE
Last Name:ZIMCOSKY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:795 OUTRIGGER CV
Mailing Address - Street 2:
Mailing Address - City:PAINESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44077-4689
Mailing Address - Country:US
Mailing Address - Phone:440-796-7114
Mailing Address - Fax:
Practice Address - Street 1:795 OUTRIGGER CV
Practice Address - Street 2:
Practice Address - City:PAINESVILLE
Practice Address - State:OH
Practice Address - Zip Code:44077-4689
Practice Address - Country:US
Practice Address - Phone:440-796-7114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2008-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP-6892235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist