Provider Demographics
NPI:1881352755
Name:LESON, ANNA LAYNE (SLP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:LAYNE
Last Name:LESON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 CRAIG VIEW WAY
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-2694
Mailing Address - Country:US
Mailing Address - Phone:850-381-3949
Mailing Address - Fax:
Practice Address - Street 1:1208 CRAIG VIEW WAY
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-2694
Practice Address - Country:US
Practice Address - Phone:850-381-3949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-07
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC30002399235Z00000X
FLSA19084235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist