Individual
VIRGINIA WATTERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
305 E JEFFERSON ST, BOISE, ID 83712-6231
(208) 345-0715
(208) 345-1142
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
LCSW43511
ID
Other
Enumeration date
12/31/2012
Last updated
12/31/2025
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