Individual
RHEANON RENE' SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
6933 W EMERALD ST STE 100, BOISE, ID 83704-8616
(208) 321-0634
Mailing address
6933 W EMERALD ST, BOISE, ID 83704-8616
(208) 321-0634
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LCPC5443
ID
101Y00000X
Counselor
Primary
LPC 4616
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265565477
—
ID
05
—
1396023065
—
ID
Enumeration date
07/29/2011
Last updated
02/14/2019
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