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Individual

SHANNON TROY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
9482 W FAIRVIEW AVE, BOISE, ID 83704-8101
(208) 375-3230
Mailing address
1433 N ELLINGTON PL, EAGLE, ID 83616-4079
(208) 602-7172

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC5381711
ID

Other

Enumeration date
05/27/2026
Last updated
05/27/2026
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