Provider Demographics
NPI:1528294261
Name:ATER, LESLEY ANN (MA,CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:LESLEY
Middle Name:ANN
Last Name:ATER
Suffix:
Gender:F
Credentials:MA,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17428 HIGH ST.
Mailing Address - Street 2:PO BOX 166
Mailing Address - City:CLARKSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43115
Mailing Address - Country:US
Mailing Address - Phone:740-993-2592
Mailing Address - Fax:
Practice Address - Street 1:272 HOSPITAL RD
Practice Address - Street 2:REHABILITATION SERVICES - 3 RD FLOOR
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-9031
Practice Address - Country:US
Practice Address - Phone:740-779-7690
Practice Address - Fax:740-779-7697
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2009-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP6212235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist