Organization
A BALANCED LIFE EXPERIENCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN J MOORE LCPC, NCC (OWNER/COUNSELOR)
(208) 841-3581
Entity
Organization
Contact information
Practice address
4696 W OVERLAND RD, SUITE 118, BOISE, ID 83705-2845
(208) 841-3581
Mailing address
4696 W OVERLAND RD, SUITE 118, BOISE, ID 83705-2845
(208) 841-3581
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-3938
ID
101YM0800X
Mental Health Counselor
LPC-3839
ID
Other
Enumeration date
04/06/2010
Last updated
04/03/2013
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