Individual
LESLIE LYNN DAVIDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1408 W HAYS ST, BOISE, ID 83702-5028
(208) 918-0287
Mailing address
1408 W HAYS ST, BOISE, ID 83702-5028
(208) 918-0287
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT-5453
ID
106H00000X
Marriage & Family Therapist
MFC 46203
CA
Other
Enumeration date
09/09/2016
Last updated
09/09/2016
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