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General NPI Number Information
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NPI Number | 1619358330
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Entity Type | Individual
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Provider Name | LESLEY-ANN BOVELL
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Gender | Female
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Dates
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Enumeration Date | 06/18/2015
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Last Update Date | 11/13/2017
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Provider Practice Location Address
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Address Line | 4600 POWDER MILL RD SUITE N
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City | BELTSVILLE
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State | MD
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Zip | 20705-2675
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Country | US
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Telephone | 240-522-6864
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Fax |
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Provider Business Mailing Address
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Address Line | 10610 RHODE ISLAND AVE STE 204
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City | BELTSVILLE
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State | MD
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Zip | 20705-2500
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Country | US
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Telephone | 301-358-1128
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP000482
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 07478
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License Number State | MD
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