Individual
MRS. WANDA LEE NEWTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED
Contact information
Practice address
901 MAIN STREET, SUITE B, CALDWELL, ID 83605
(208) 454-2471
Mailing address
901 MAIN STREET, SUITE B, CALDWELL, ID 83605
(208) 454-2471
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC39
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010016162
REGENCE BLUE SHIELD
ID
01
—
Q299D
BLUE CROSS
ID
Enumeration date
12/08/2006
Last updated
07/08/2007
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