Individual
LESLIE ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
13176 W PERSIMMON LN STE 120, BOISE, ID 83713-5027
(208) 376-3591
Mailing address
245 N 3RD E, MOUNTAIN HOME, ID 83647-2734
(208) 587-8255
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-3063
ID
Other
Enumeration date
08/11/2015
Last updated
11/21/2017
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