Individual
DANIELLE WAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LISW
Contact information
Practice address
800 W MAIN ST STE 1460, BOISE, ID 83702-5983
(208) 371-7213
Mailing address
PO BOX 508, KUNA, ID 83634-0508
(208) 371-7213
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW-38078
ID
Other
Enumeration date
05/23/2017
Last updated
02/19/2021
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