Burgess, Leslie
Burgess, Leslie is an sole proprietor health care provider with primary practice located at 821 S Orange St , Missoula MT 59801-3833. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Burgess, Leslie can be contacted via phone (406) 542-5655.Contact Information
Primary practice address
821 S Orange St
Missoula MT 59801-3833
Phone: (406) 542-5655
Fax: (406) 542-7005
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 289 | Montana |
Profile Details
| NPI number | 1033274402 |
|---|---|
| LBN Legal business name | Burgess, Leslie |
| Credentials | L.C.P.C. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 26th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033274402 | NPPES |
| Montana | MEDICAID | 0250003 | |
| Montana | Other | 74681 |
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