Individual
SHAUNNA BACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS,LPC,NCC,
Contact information
Practice address
4060 E CHINDEN BLVD, EAGLE, ID 83616-6481
(208) 629-6850
Mailing address
3999 W COLUMBIA RD, MERIDIAN, ID 83642-7113
(208) 629-6850
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-5266
ID
Other
Enumeration date
02/26/2014
Last updated
02/26/2014
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