Doctor Name: | DR. LESLIE E GLAZE |
NPI Number: | 1457578775 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D., CCC-S |
License Number: | 5281 |
Business Practice Address: | University Of Minnesota 164 Pillsbury Drive Se Minneapolis, MN - 55455 |
Business Phone Number: | 6126243322 |
Business Fax Number: | |
Mailing Address: | 11705 - 27th Avenue North, PLYMOUTH |
State: | MN |
Postal Code: | 55441 |
Phone Number: | 7635571840 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 5281 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
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 |