Individual
AMANDA ROSE WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3006 E GOLDSTONE DR, MERIDIAN, ID 83642-1549
(208) 614-3413
Mailing address
3006 E GOLDSTONE DR, MERIDIAN, ID 83642-1549
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-8499
ID
Other
Enumeration date
11/17/2021
Last updated
07/07/2025
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