Provider Demographics
NPI:1790220721
Name:SAYLOR, LESLIE KAY (MA ED)
Entity type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:KAY
Last Name:SAYLOR
Suffix:
Gender:F
Credentials:MA ED
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:KAY
Other - Last Name:SAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:620 LAUREL FORD RD
Mailing Address - Street 2:
Mailing Address - City:KETTLE ISLAND
Mailing Address - State:KY
Mailing Address - Zip Code:40958-9067
Mailing Address - Country:US
Mailing Address - Phone:606-302-0303
Mailing Address - Fax:
Practice Address - Street 1:620 LAUREL FORD RD
Practice Address - Street 2:
Practice Address - City:KETTLE ISLAND
Practice Address - State:KY
Practice Address - Zip Code:40958-9067
Practice Address - Country:US
Practice Address - Phone:606-302-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-29
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
KY78847222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator