Individual
LORI LODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC LMFT
Contact information
Practice address
2971 E COPPER POINT DR, SUITE 100, MERIDIAN, ID 83642-5101
(208) 376-5683
(208) 376-5690
Mailing address
2971 E COPPER POINT DR, SUITE 100, MERIDIAN, ID 83642-5101
(208) 376-5683
(208) 376-5690
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2907
ID
106H00000X
Marriage & Family Therapist
2929
ID
Other
Enumeration date
04/01/2009
Last updated
04/01/2009
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