Individual
TRACY LYNN ROE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A., L.C.P.C., NCC
Contact information
Practice address
3350 W AMERICANA TER STE 330C, BOISE, ID 83706-2547
(208) 866-3971
Mailing address
2800 N BOGUS BASIN RD APT D103, BOISE, ID 83702-0976
(208) 866-3971
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
18781
TX
101YM0800X
Mental Health Counselor
LCPC-4651
ID
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
08/26/2009
Last updated
09/05/2024
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