Individual
MELISSA A BOLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCP
Contact information
Practice address
333 SOUTH MAIN ST STE 104, KETCHUM, ID 83340
(208) 726-7584
Mailing address
PO BOX 5865, KETCHUM, ID 83340-5865
(208) 726-7584
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
LPCP233
ID
Other
Enumeration date
02/27/2008
Last updated
02/27/2008
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