Individual
SHELBY HASENOEHRL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
822 BRYDEN AVE, LEWISTON, ID 83501-4928
(208) 984-9794
Mailing address
822 BRYDEN AVE, LEWISTON, ID 83501-4928
(208) 984-9794
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC8280
ID
Other
Enumeration date
06/16/2021
Last updated
01/09/2023
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