Provider Demographics
NPI:1548936966
Name:LESLIE, CHLOE ANN (MA, SLP-CF)
Entity type:Individual
Prefix:MRS
First Name:CHLOE
Middle Name:ANN
Last Name:LESLIE
Suffix:
Gender:F
Credentials:MA, SLP-CF
Other - Prefix:MS
Other - First Name:CHLOE
Other - Middle Name:ANN
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:N/A
Mailing Address - Street 1:1809 INDIAN WELLS RD
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-4617
Mailing Address - Country:US
Mailing Address - Phone:575-437-1967
Mailing Address - Fax:575-437-3969
Practice Address - Street 1:1809 INDIAN WELLS RD
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-4617
Practice Address - Country:US
Practice Address - Phone:575-437-1967
Practice Address - Fax:575-437-3969
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCF7451235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist