Individual
MRS. MARIELLA ELLE GOTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., LPC, ATR-BC
Contact information
Practice address
1010 W HAYS ST, BOISE, ID 83702-5435
(208) 284-5273
Mailing address
1010 W HAYS ST, BOISE, ID 83702-5435
(208) 284-5273
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC-3004
ID
103T00000X
Psychologist
Primary
PSY-202270
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1326172644
—
ID
Enumeration date
03/16/2007
Last updated
05/02/2023
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