MEDICARE: SHERRI L LESLIE M.A. 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	SP-8019	OH

General Provider Information

NPI Number	:	1619208014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRI L LESLIE M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	28711 W OAKLAND RD
Second Line	:
City	:	BAY VILLAGE
State	:	OH
Zip	:	44140-2042
Country	:	US
Telephone Number	:	440-835-4961
Fax Number	:

Provider Business Practice Location Address
First Line	:	3430 ROCKY RIVER DR
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-2954
Country	:	US
Telephone Number	:	440-227-8664
Fax Number	:

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

Provider Enumeration Date	:	01/25/2010
Last Update Date	:	01/25/2010

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Directions to “ SHERRI L LESLIE M.A. CCC-SLP” Practice Location

Language	Start Address	Practice Location

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