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Organization

VIRGINIA SPACKMAN LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VIRGINIA L SPACKMAN M.ED, LCPC (OWNER)
(208) 409-3050
Entity
Organization

Contact information

Practice address
1068 OWYHEE ST, KUNA, ID 83634-2206
(208) 409-3050
Mailing address
1068 OWYHEE ST, KUNA, ID 83634-2206
(208) 409-3050

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
09/01/2022
Last updated
09/01/2022
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