Provider Demographics
NPI:1780648808
Name:GAUGHRAN, LESLIE EVERS (MS CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:EVERS
Last Name:GAUGHRAN
Suffix:
Gender:F
Credentials:MS CCC SLP
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Mailing Address - Street 1:360 S WAVERLY PLACE
Mailing Address - Street 2:#6A
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960
Mailing Address - Country:US
Mailing Address - Phone:772-532-4780
Mailing Address - Fax:772-563-4935
Practice Address - Street 1:360 S WAVERLY PLACE
Practice Address - Street 2:#6A
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960
Practice Address - Country:US
Practice Address - Phone:772-532-4780
Practice Address - Fax:772-563-4935
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLSA7297235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist