Organization
OAK AND IVY THERAPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE JOHNSON LPC, CCTP, CLC, M.ED (OWNER)
(206) 823-7829
Entity
Organization
Contact information
Practice address
6063 S ACHERON AVE, BOISE, ID 83709-6191
(206) 823-7829
Mailing address
6063 S ACHERON AVE, BOISE, ID 83709-6191
(206) 823-7829
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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