Individual
MS. CAROL COVINGTON HACKNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.P.C.
Contact information
Practice address
500 W BANNOCK ST, BOISE, ID 83702-5916
(208) 336-3900
(208) 342-6553
Mailing address
500 W BANNOCK ST, BOISE, ID 83702-5916
(208) 336-3900
(208) 342-6553
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-341
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q2093
BLUE CROSS
ID
Enumeration date
09/13/2006
Last updated
07/08/2007
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