Individual
LISA M BROKAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
2176 E FRANKLIN RD STE 100, MERIDIAN, ID 83642-8009
(208) 515-7661
Mailing address
477 N STEAR AVE, KUNA, ID 83634-5004
(208) 570-0503
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-6942
ID
Other
Enumeration date
08/08/2018
Last updated
08/08/2018
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