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General NPI Number Information
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NPI Number | 1508798596
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Entity Type | Individual
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Provider Name | CHRISTINE LEDBETTER
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Gender | Female
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Dates
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Enumeration Date | 06/02/2026
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Last Update Date | 06/02/2026
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Provider Practice Location Address
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Address Line | 240 S MAIN ST
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City | SODA SPRINGS
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State | ID
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Zip | 83276-5215
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Country | US
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Telephone | 208-221-1196
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Fax |
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Provider Business Mailing Address
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Address Line | 1486 HAWKER EXT
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City | SODA SPRINGS
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State | ID
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Zip | 83276-5666
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Country | US
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Telephone | 208-221-1196
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LCPC-5126
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License Number State | ID
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