Individual
NICHOLAS MANFREDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LPC
Contact information
Practice address
890 N COLE RD, BOISE, ID 83704-8614
(208) 322-1026
Mailing address
890 N COLE RD, BOISE, ID 83704-8614
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-5735
ID
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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