Individual
NICOLE BERENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4346 W ROSE HILL ST STE C, BOISE, ID 83705-5193
(208) 963-8132
(208) 203-0942
Mailing address
4346 W ROSE HILL ST STE C, BOISE, ID 83705-5193
(208) 963-8132
(208) 203-0942
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-8203
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285128124
—
ID
Enumeration date
06/14/2018
Last updated
11/16/2022
About Stedi
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