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Individual

CHRISTA M STALLWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
410 S ORCHARD ST STE 184, BOISE, ID 83705-1293
(208) 214-7408
Mailing address
PO BOX 6454, BOISE, ID 83707-6454
(580) 284-5338

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-7657
ID

Other

Enumeration date
10/16/2014
Last updated
04/23/2025
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