Individual
LEANN LESLIE MORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3525 E LOUISE DR, MERIDIAN, ID 83642-6302
(208) 706-7050
Mailing address
3525 E LOUISE DR, MERIDIAN, ID 83642-6302
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
33255
ID
Other
Enumeration date
04/28/2021
Last updated
11/29/2021
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