Individual
LESENA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 S ORCHARD ST STE 110, BOISE, ID 83705-1961
(208) 919-4692
Mailing address
485 N WHITEWATER PARK BLVD APT B202, BOISE, ID 83702-5693
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/09/2026
Last updated
06/09/2026
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