Individual
MS. PAMELA P ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A. COUN., LCPC
Contact information
Practice address
4346 W ROSE HILL ST STE A, BOISE, ID 83705-5193
(208) 830-0601
Mailing address
1116 S VISTA AVE # 287, BOISE, ID 83705-2429
(208) 830-0601
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-6682
ID
101YM0800X
Mental Health Counselor
LCPC-C6682
ID
101YM0800X
Mental Health Counselor
LPC-5003
ID
Other
Enumeration date
09/10/2012
Last updated
06/08/2023
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