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Individual
LESLIE MOSES BOUTTE
Active
Individual
LESLIE MOSES BOUTTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC-S, RPT-S
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
70164
TX
101YP2500X
Professional Counselor
Primary
70164
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
329211201
—
TX
Enumeration date
05/11/2015
Last updated
03/04/2022
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