Individual
SHANELL WALLENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3061 S MERIDIAN RD STE 100, MERIDIAN, ID 83642-7962
(208) 620-5399
(208) 576-6915
Mailing address
2886 S TAGISH WAY, MERIDIAN, ID 83642-9190
(208) 272-1563
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-9724
ID
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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