Provider Demographics
NPI:1881946820
Name:CRAMER, LESLIE REYNOLDS (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:REYNOLDS
Last Name:CRAMER
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 1:24 ZENITH LOOP
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23601-1270
Mailing Address - Country:US
Mailing Address - Phone:757-262-8695
Mailing Address - Fax:
Practice Address - Street 1:245 CHESAPEAKE AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23607-6038
Practice Address - Country:US
Practice Address - Phone:757-928-8260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006355235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist