Individual
LEANN W VATERLAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
6126 W STATE ST, BOISE, ID 83703-2741
(208) 391-5941
(208) 593-4807
Mailing address
6126 W STATE ST, BOISE, ID 83703-2741
(208) 391-5941
(208) 593-4807
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-43080
ID
104100000X
Social Worker
LMSW-43080
ID
Other
Enumeration date
09/25/2023
Last updated
08/26/2024
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