Individual
AMANDA P EISENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LAMFT
Contact information
Practice address
1407 N 13TH ST, BOISE, ID 83702-3531
(970) 519-1466
Mailing address
1605 N 10TH ST, BOISE, ID 83702-3627
(970) 519-1466
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-7288
ID
Other
Enumeration date
08/06/2019
Last updated
08/06/2019
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