Individual
LESLIE BRACKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
11960 WESTLINE INDUSTRIAL DR, SUITE 201, SAINT LOUIS, MO 63146-3209
(314) 819-0480
Mailing address
926 NAPOLI DR, BALLWIN, MO 63021-6442
(636) 346-5890
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01755
MO
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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