Individual
MEADOW MARIE CLERICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
2463 E GALA ST STE 100, MERIDIAN, ID 83642-5210
(208) 955-7339
(208) 955-7330
Mailing address
2463 E GALA ST STE 100, MERIDIAN, ID 83642-5210
(208) 955-7339
(208) 955-7330
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
ID
103T00000X
Psychologist
Primary
—
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
ID
Other
Enumeration date
07/14/2022
Last updated
07/14/2022
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