Individual
CAROLINE VIEIRA MARINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
112 9TH AVE S STE B4, NAMPA, ID 83651-3825
(208) 261-1076
(208) 586-5120
Mailing address
2872 S PINE FLATS WAY, MERIDIAN, ID 83642-9140
(310) 210-1664
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-10031
ID
101YM0800X
Mental Health Counselor
LPC-6977
ID
Other
Enumeration date
10/01/2018
Last updated
03/08/2024
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