Individual
MELANIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10740 W FAIRVIEW AVE STE 100, BOISE, ID 83713-8050
(208) 376-0191
Mailing address
10740 W FAIRVIEW AVE STE 100, BOISE, ID 83713-8050
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-6194
ID
Other
Enumeration date
09/12/2016
Last updated
09/12/2016
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