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Individual

MRS. AMANDA LACHANCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, LPC

Contact information

Practice address
5353 FRANKLIN RD, BOISE, ID 83705-1112
(208) 342-0374
(208) 331-2017
Mailing address
5353 FRANKLIN RD, BOISE, ID 83705-1112
(208) 342-0374
(208) 331-2017

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-3571
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010165071
REGENCE BLUE SHIELD OF ID
05
807499000
ID
Enumeration date
02/12/2008
Last updated
02/12/2008
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