Individual
MRS. ROSEMARY LADACY LUQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
4172 N CRESWELL WAY, BOISE, ID 83713-2403
(208) 863-1404
(833) 340-7217
Mailing address
4172 N CRESWELL WAY, BOISE, ID 83713-2403
(208) 863-1404
(833) 340-7217
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC3480
ID
101YM0800X
Mental Health Counselor
LPC-2773
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010140465
REGENCE BLUESHIELD ID #
ID
01
—
200000062851
BLUE CROSS OF IDAHO
ID
05
—
7365212
—
ID
Enumeration date
09/20/2005
Last updated
01/12/2024
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