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Individual

AMITY HEYBORNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
211 E PINE AVE STE 106, MERIDIAN, ID 83642-2321
(208) 954-1527
Mailing address
594 W KODIAK DR, MERIDIAN, ID 83642-8119
(208) 954-1527

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-9513
ID

Other

Enumeration date
11/07/2024
Last updated
11/07/2024
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