Individual
TALMAGE W DELANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED, LCPC
Contact information
Practice address
235 NORTH 3RD EAST, MOUNTAIN HOME, ID 83647
(208) 724-8120
(208) 587-2992
Mailing address
115 DEWEY STREET, MOUNTAIN HOME, ID 83647
(208) 724-8120
(208) 587-2992
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC 382
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q5944
BLUE CROSS BLUE SHIELD
ID
Enumeration date
10/03/2006
Last updated
07/08/2007
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