Individual
LISA K HETTENHAUSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
8400 W FAIRVIEW AVE, BOISE, ID 83704-8317
(208) 322-5859
(208) 322-5901
Mailing address
8400 W FAIRVIEW AVE, BOISE, ID 83704-8317
(208) 322-5859
(208) 322-5901
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT-3011
ID
Other
Enumeration date
03/02/2011
Last updated
03/02/2011
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