Individual
MS. LESLEY DIANA LUTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
906 W UNIVERSITY AVE, STE 120, FLAGSTAFF, AZ 86001
(928) 556-9935
(928) 774-4277
Mailing address
906 W UNIVERSITY AVE, STE 120, FLAGSTAFF, AZ 86001
(928) 556-9935
(928) 774-4277
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
3772
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0308290
BLUE CROSS BLUE SHIELD
—
Enumeration date
12/28/2006
Last updated
07/08/2007
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