MEDICARE: MRS. LESLIE RENEE FLOWERS MS CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	2978	OK

General Provider Information

NPI Number	:	1609047679
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LESLIE RENEE FLOWERS MS CCC-SLP

Provider Business Mailing Address
First Line	:	8301 MELANIE WAY
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73025-1561
Country	:	US
Telephone Number	:	405-370-4570
Fax Number	:

Provider Business Practice Location Address
First Line	:	8301 MELANIE WAY
Second Line	:
City	:	EDMOND
State	:	OK
Zip	:	73025-1561
Country	:	US
Telephone Number	:	405-370-4570
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/18/2008
Last Update Date	:	04/19/2010

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