Individual
LISA M CORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1370 CALDWELL BLVD STE 4, NAMPA, ID 83651-1768
(208) 442-9419
Mailing address
9520 GLORIA RD, MIDDLETON, ID 83644-5044
(208) 941-3213
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-9520
ID
Other
Enumeration date
06/06/2023
Last updated
03/30/2024
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