NPI age
17 years
Enumerated 2009-04-13
Across 1313 active counselor providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (WA) | LH60086695 | STATE LICENSURE |
| 01 (ID) | LCPC-4160 | STATE LICENSURE |
Part of a multi-provider practice. 12 other active providers share this practice address in NPPES.
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