Doctor Name: | LESLIE W DALTON |
NPI Number: | 1043571938 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 104700 |
Business Practice Address: | 2501 4th Ave Canyon, TX - 790160001 |
Business Phone Number: | 8066515108 |
Business Fax Number: | 8066515105 |
Mailing Address: | 2415 15th Ave, CANYON |
State: | TX |
Postal Code: | 790155519 |
Phone Number: | 8066560788 |
Fax Number: | |
NPI Enumeration Date: | 06/06/2012 |
NPI Last Update Date: | 10/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 104700 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |