Individual
TYRA NOELL PEONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9259 W STONEHAM DR, BOISE, ID 83714-6705
(917) 727-0486
Mailing address
9259 W STONEHAM DR, BOISE, ID 83714-6705
(917) 727-0486
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
1041C0700X
Clinical Social Worker
Primary
8911149
ID
1041C0700X
Clinical Social Worker
L17498
OR
Other
Enumeration date
01/18/2022
Last updated
03/24/2026
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