Provider Demographics
NPI:1730768771
Name:BARNETTE, LESHEA
Entity type:Individual
Prefix:
First Name:LESHEA
Middle Name:
Last Name:BARNETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8134 NC HWY 90 E
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NC
Mailing Address - Zip Code:28678-9554
Mailing Address - Country:US
Mailing Address - Phone:704-437-1912
Mailing Address - Fax:
Practice Address - Street 1:1016 FLETCHER ST
Practice Address - Street 2:
Practice Address - City:WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28697-9472
Practice Address - Country:US
Practice Address - Phone:336-667-9261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14084235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist