Individual
SUSAN VIRGINIA PENNINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, MFTI
Contact information
Practice address
1407 N 13TH ST, BOISE, ID 83702-3531
(208) 400-3352
Mailing address
1407 N 13TH ST, BOISE, ID 83702-3531
(208) 400-3352
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/25/2013
Last updated
08/12/2019
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