Individual
MRS. ANGELA MOONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3619 N 3400 E, KIMBERLY, ID 83341-5288
(208) 731-6347
Mailing address
3619 N 3400 E, KIMBERLY, ID 83341-5288
(208) 731-6347
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-4925
ID
Other
Enumeration date
07/13/2012
Last updated
07/13/2012
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