Individual
FATUMA Y MNONGERWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 S ORCHARD ST STE 245, BOISE, ID 83705-1964
(208) 570-4798
Mailing address
15564 FUCHSIA AVE, NAMPA, ID 83651-5100
(208) 570-4798
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-44431
ID
Other
Enumeration date
12/07/2023
Last updated
12/07/2023
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