MEDICARE: LESLIE R. FLOWERS, MS CCC-SLP/PC

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639436751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LESLIE R. FLOWERS, MS CCC-SLP/PC

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

Provider Enumeration Date	:	04/13/2012
Last Update Date	:	04/13/2012

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