NPI age
18 years
Enumerated 2008-01-10
Across 1998 active counselor providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (WA) | LH60249089 | PROVIDER LICENSE WA STATE |
| 01 (ID) | LCPC-6701 | PROVIDER LICENSE STATE OF IDAHO |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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