Organization
MUSIC THERAPY OF IDAHO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE LEAVELL MT-BC (MUSIC THERAPIST)
(208) 371-9102
Entity
Organization
Contact information
Practice address
11210 W HICKORY LOOP DR, BOISE, ID 83713-1031
(208) 371-9102
Mailing address
11210 W HICKORY LOOP DR, BOISE, ID 83713-1031
Taxonomy
Speciality
Code
Description
License number
State
225A00000X
Music Therapist
Primary
—
—
Other
Enumeration date
02/09/2011
Last updated
02/09/2011
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