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Individual

LESLIE GREGORY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
499 W BOUNDRY, 275 W. MAIN, KANSAS, OK 74347-1662
(918) 868-2567
(918) 868-5584
Mailing address
10410 E 540, SALINA, OK 74365-2526
(918) 521-7172
(918) 868-5584

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2960
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100680100A
OK
Enumeration date
06/11/2015
Last updated
06/11/2015
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