Individual
LESLIE BARTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC-3667
Contact information
Practice address
1740 E 17TH ST STE B, IDAHO FALLS, ID 83404-6375
(208) 529-8832
(208) 522-8725
Mailing address
1148 SHADOW MOUNTAIN CT, IDAHO FALLS, ID 83404-8245
(208) 542-0309
(208) 681-0710
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC3667
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010156105
BLUE SHIELD OF IDAHO
ID
01
—
7819838
AETNA
ID
01
—
X6892
BLUE CROSS OF IDAHO
ID
Enumeration date
03/15/2007
Last updated
07/09/2007
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