Provider Demographics
NPI:1740406222
Name:MCNISH-FISHER, LESLIE MARIE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:MARIE
Last Name:MCNISH-FISHER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MRS
Other - First Name:LESLIE
Other - Middle Name:MARIE
Other - Last Name:MCNISH-MONTEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA,CCC-SLP
Mailing Address - Street 1:42562 BUSH RD
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:CO
Mailing Address - Zip Code:81022-9768
Mailing Address - Country:US
Mailing Address - Phone:719-948-5335
Mailing Address - Fax:
Practice Address - Street 1:4112 OUTLOOK BLVD
Practice Address - Street 2:SUITE # 96
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-1667
Practice Address - Country:US
Practice Address - Phone:719-562-6200
Practice Address - Fax:719-562-6166
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist