Individual
MRS. JUDITH D IGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1408 W HAYS, BOISE, ID 83702-1862
(208) 387-1741
Mailing address
1734 E BRAEMERE RD, BOISE, ID 83702-1862
(208) 387-1734
(208) 383-1199
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC 129
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q3790
BLUE CROSS INS
ID
Enumeration date
12/08/2006
Last updated
07/08/2007
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