Individual
RONI MELTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
8182 N WAYNE DRIVE, SUITE C, HAYDEN, ID 83835
(208) 762-8777
Mailing address
8182 N WAYNE DRIVE, SUITE C, HAYDEN, ID 83835
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
10105
ID
Other
Enumeration date
08/02/2024
Last updated
08/02/2024
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