Organization
LACEY MACKENZIE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACEY JILL MACKENZIE LPC (MENTAL HEALTH COUNSELOR)
(208) 739-0982
Entity
Organization
Contact information
Practice address
1509 N WHITLEY DR, SUITE 11, FRUITLAND, ID 83619-2259
(208) 739-0982
Mailing address
PO BOX 173, WEISER, ID 83672-0173
(208) 739-0982
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC-4348
ID
Other
Enumeration date
03/07/2011
Last updated
03/07/2011
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