Individual
GENELYN REAS MAIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
623 S UNIVERSITY BLVD, NAMPA, ID 83686-5800
(208) 717-5979
Mailing address
623 S UNIVERSITY BLVD, NAMPA, ID 83686-5800
(208) 717-5979
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8141
ID
Other
Enumeration date
05/07/2021
Last updated
06/15/2023
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