Individual
CARLY ODE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
220 10TH AVE S, NAMPA, ID 83651-3832
(208) 468-0850
Mailing address
1018 N WEBB WAY UNIT F201, MERIDIAN, ID 83642-8364
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
ID
Other
Enumeration date
10/15/2025
Last updated
10/15/2025
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