Individual
LESLEE SHELLY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
168 NORTH JOHNSTON ST, SUITE 104, DALLAS, GA 30132
(770) 443-9672
(770) 505-3595
Mailing address
168 NORTH JOHNSTON ST, SUITE 104, DALLAS, GA 30132
(770) 443-9672
(770) 505-3595
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006131
GA
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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