Leslie, Jodi

Leslie, Jodi is an individual health care provider with primary practice located at 1275 Big Flat Rd , Missoula MT 59804-9217. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Leslie, Jodi can be contacted via phone (406) 728-1413.

Contact Information

Primary practice address
1275 Big Flat Rd Missoula MT 59804-9217
Phone: (406) 728-1413
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 960 Montana
Behavioral Health & Social Service Providers / Psychologist 103T00000X 115184-2501 Utah

Profile Details

NPI number 1447301981
LBN Legal business name Leslie, Jodi
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 12th, 2007
Last updated Nov 30th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447301981 NPPES
Montana Other 944653 LCPC
Montana MEDICAID 0000253164 LCPC

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