Individual
GENNA MICHELLE ROSE LOVELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2650 S EAGLE RD STE 110, MERIDIAN, ID 83642-6745
(986) 200-4290
Mailing address
7766 S GREENACRES DR, BOISE, ID 83709-6864
(541) 815-5150
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
42345
ID
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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