Individual
LESLIE BURGESS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.P.C.
Contact information
Practice address
821 S ORANGE ST, MISSOULA, MT 59801-3833
(406) 542-5655
(406) 542-7005
Mailing address
821 S ORANGE ST, MISSOULA, MT 59801-3833
(406) 542-5655
(406) 542-7005
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
289
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0250003
—
MT
01
—
74681
BCBS
MT
Enumeration date
12/26/2006
Last updated
07/08/2007
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