Individual
SAMANTHA LEAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
145 E DEER FLAT RD, KUNA, ID 83634-1323
(208) 922-9001
Mailing address
145 E DEER FLAT RD, KUNA, ID 83634-1323
(208) 922-9001
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW-42074
ID
101YM0800X
Mental Health Counselor
LMSW-35831
ID
Other
Enumeration date
06/30/2021
Last updated
10/18/2022
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