Individual
BILLYLYNN LEIUILANI HAN PESTELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
410 S ORCHARD ST STE 124, BOISE, ID 83705-1210
(208) 398-0826
Mailing address
6692 W MORRIS HILL LN APT 103, BOISE, ID 83704-9282
(208) 398-0826
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
BBH-LCSW-LIC-33967
MT
1041C0700X
Clinical Social Worker
Primary
LCSW-43502
ID
Other
Enumeration date
04/22/2019
Last updated
05/22/2024
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