Individual
LESLIE ANN BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCD, CCC-SLP
Contact information
Practice address
6140 WOODSIDE EXECUTIVE CT, AIKEN, SC 29803-3820
(803) 642-0700
Mailing address
275 ORCHARD WAY, NORTH AUGUSTA, SC 29860-7595
(864) 963-0404
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5194
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14058149
ASHA CERTIFICATION
—
01
—
5194
STATE LICENSE
SC
Enumeration date
06/11/2013
Last updated
06/11/2013
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