NPI | 1457712127 |
---|---|
Former Name | LESLIE LESSARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CT 4716) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 4264) |
Enumeration Date | 2016-03-09 |
Last Update Date | 2019-10-21 |