Individual
MRS. DIANA L PALS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. ED.
Contact information
Practice address
814 S WASHINGTON ST, MOSCOW, ID 83843-3049
(208) 883-0619
(208) 882-4774
Mailing address
814 S WASHINGTON ST, MOSCOW, ID 83843-3049
(208) 883-0619
(208) 882-4774
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC -167
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010015830
REGENCE BLUE SHIELD
ID
01
—
137333137335
PREMERA BLUE CROSS
ID
01
—
Q107-5
BLUE CROSS OF IDAHO
ID
Enumeration date
07/17/2006
Last updated
07/08/2007
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