Healthcare Provider Details

I. General information

NPI: 1730335795
Provider Name (Legal Business Name): LESLEY POWELL THOMAS MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2008
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 W SALISBURY ST
DENTON NC
27239-6944
US

IV. Provider business mailing address

119 SHAWNEE RD
LEXINGTON NC
27295-2136
US

V. Phone/Fax

Practice location:
  • Phone: 336-242-5708
  • Fax:
Mailing address:
  • Phone: 828-508-1114
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number6719
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: