Individual
MS. LESLIE JEAN BOULETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
328 MAIN ST, SOUTHBRIDGE, MA 01550-3727
(508) 765-9101
(508) 764-4389
Mailing address
328 MAIN ST, SOUTHBRIDGE, MA 01550-3727
(508) 765-9101
(508) 764-4389
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/06/2010
Last updated
07/19/2014
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