Individual
LESLIE FREDERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
2114 N 127TH ST E, WICHITA, KS 67206-3003
(316) 500-8800
(316) 500-8818
Mailing address
2920 N WOODRIDGE CT, WICHITA, KS 67226-6403
(620) 640-1267
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3628
KS
Other
Enumeration date
05/20/2014
Last updated
05/28/2019
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