Individual
MS. HOLLEY REILLY BLITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA MFT
Contact information
Practice address
4750 N FIVE MILE RD, BOISE, ID 83713-2715
(208) 996-0931
Mailing address
4750 NORTH MILE ROAD, BOISE, ID 83713
(208) 996-0932
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT-8097
ID
106H00000X
Marriage & Family Therapist
MFT33818
CA
Other
Enumeration date
09/16/2006
Last updated
08/17/2023
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