Individual
MS. ELENA MARIA MABANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3852 N EAGLE RD, BOISE, ID 83713-0750
(208) 378-0014
Mailing address
3997 S CONSTITUTION WAY, BOISE, ID 83706-5817
(503) 545-0481
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2381112
ID
Other
Enumeration date
07/21/2026
Last updated
07/21/2026
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