Individual
MATECE LYDIA DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
210 W BURNSIDE AVE, CHUBBUCK, ID 83202-4916
(208) 238-9000
Mailing address
1701 MOUNTAIN VIEW DR, MCCAMMON, ID 83250-1645
(208) 851-6625
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2381218
ID
Other
Enumeration date
06/05/2026
Last updated
06/05/2026
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