Individual
CORBY WEEAKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
1015 W HAYS ST STE 105, BOISE, ID 83702-5412
(208) 398-3160
Mailing address
1833 S KIMBALL PL, BOISE, ID 83709-1658
(325) 450-4784
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10589
ID
Other
Enumeration date
08/12/2024
Last updated
08/12/2024
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