Individual
MRS. NANCY MANRIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
531 E 5TH ST, BURLEY, ID 83318-1469
(208) 678-3555
(208) 678-3556
Mailing address
PO BOX 969, BURLEY, ID 83318-0969
(208) 678-3555
(208) 678-3556
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-6815
ID
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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