Provider Demographics
NPI:1861571952
Name:HERR, LESLIE A (SLP)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:A
Last Name:HERR
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:A
Other - Last Name:CHEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:1808 AMERICAN WAY
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81401-7616
Mailing Address - Country:US
Mailing Address - Phone:970-249-8023
Mailing Address - Fax:
Practice Address - Street 1:1808 AMERICAN WAY
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81401-7616
Practice Address - Country:US
Practice Address - Phone:970-249-8023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CON/A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist