Individual
MRS. ILA MARIE FICA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
303 N 12TH AVE, POCATELLO, ID 83201-4746
(208) 221-6443
Mailing address
303 N 12TH AVE, POCATELLO, ID 83201-4746
(208) 221-6443
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-4790
ID
Other
Enumeration date
10/22/2011
Last updated
10/22/2011
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