Individual
LESLIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
5585 PERSHING AVE, SAINT LOUIS, MO 63112-4621
(314) 531-1770
(314) 381-6796
Mailing address
5701 DELMAR BLVD, SAINT LOUIS, MO 63112-2617
(314) 531-1770
(317) 771-9485
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2014001232
MO
Other
Enumeration date
12/18/2014
Last updated
02/27/2017
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