Individual
DR. REGINA ROSE MORO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LMHC, NCC
Contact information
Practice address
1510 N 28TH ST, BOISE, ID 83703-5903
(208) 917-3123
Mailing address
1510 N 28TH ST, BOISE, ID 83703-5903
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2481
NC
101YM0800X
Mental Health Counselor
MH14193
FL
101YP2500X
Professional Counselor
Primary
6380
ID
Other
Enumeration date
10/27/2020
Last updated
10/27/2020
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