Individual
LARA LEIGH VICK-ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1009 W HEMINGWAY BLVD, NAMPA, ID 83651-1763
(208) 453-8915
Mailing address
6145 N QUEENSBURY PL, BOISE, ID 83713-0977
(208) 761-0072
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-3737
ID
Other
Enumeration date
05/24/2010
Last updated
05/24/2010
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