Provider Demographics
NPI:1891165841
Name:DUPERTUIS, LESLEE L (MS-SLP, PHD)
Entity Type:Individual
Prefix:DR
First Name:LESLEE
Middle Name:L
Last Name:DUPERTUIS
Suffix:
Gender:F
Credentials:MS-SLP, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:924 BLUESTEM BLVD
Mailing Address - Street 2:
Mailing Address - City:PUEBLO
Mailing Address - State:CO
Mailing Address - Zip Code:81001-1141
Mailing Address - Country:US
Mailing Address - Phone:719-289-8500
Mailing Address - Fax:
Practice Address - Street 1:704 FORTINO BLVD
Practice Address - Street 2:
Practice Address - City:PUEBLO
Practice Address - State:CO
Practice Address - Zip Code:81008-2086
Practice Address - Country:US
Practice Address - Phone:719-305-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0001125235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist