Individual
LESLIE TANENBAUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSP, CCC-SLP
Contact information
Practice address
420 THE PKWY STE M, GREER, SC 29650-5205
(864) 244-3474
Mailing address
2 IVY LOG CT, GREENVILLE, SC 29609-6020
(843) 270-1497
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5355
SC
Other
Enumeration date
08/20/2014
Last updated
08/20/2014
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