Provider Demographics
NPI:1316974116
Name:TAYLOR, LESLEE (PHD, ATC, LAT)
Entity type:Individual
Prefix:
First Name:LESLEE
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:PHD, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 ROE BLVD
Mailing Address - Street 2:
Mailing Address - City:ROELAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2445
Mailing Address - Country:US
Mailing Address - Phone:068-241-3198
Mailing Address - Fax:
Practice Address - Street 1:3901 RAINBOW BLVD # MS 2002
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-0002
Practice Address - Country:US
Practice Address - Phone:913-945-5187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer