Individual
BROOKE LESLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
520 S EAGLE RD STE 1229, MERIDIAN, ID 83642-6355
(208) 383-0190
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-43447
ID
Other
Enumeration date
08/20/2021
Last updated
05/09/2023
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