Leslie Jefferson
Individual provider Active NPI Speech-Language Pathologist · Summit, AR
NPI 1831559129 · NPPES record last updated Sep 26, 2022
Key facts
- NPI
- 1831559129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SP#P9004 (AR)
- Practice address
- 213 South Main Street
Summit, AR 72677 - Phone
- (870) 404-0976
- NPI assigned
- Feb 29, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP#P9004 | AR | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP#P9004 | AR | Yes |
Addresses
Primary practice location
213 South Main Street
Summit, AR 72677
Mailing address
PO Box 610
Valley Springs, AR 72682-0610
Phone (870) 302-3100
Other providers in Summit, AR
All providers in Summit, AR · Speech-Language Pathologist in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.