Individual
SARA COOKE-WALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
320 11TH AVE S STE 204, NAMPA, ID 83651-5074
(208) 717-5312
Mailing address
10094 W EDNA ST, BOISE, ID 83704-4064
(704) 280-5510
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-8202
ID
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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