Individual
SHAYLA NICOLE DEVISSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW-44697
Contact information
Practice address
6126 W. STATE STREET, BOISE, ID 83703
(208) 477-1202
Mailing address
6126 W. STATE STREET, BOISE, ID 83703-0932
(208) 477-1202
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-44697
ID
Other
Enumeration date
05/19/2021
Last updated
03/11/2024
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