Individual
MRS. MARY L MORRISEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
2995 N COLE RD, #255, BOISE, ID 83704-5964
(208) 376-0453
Mailing address
2995 N COLE RD, #255, BOISE, ID 83704-5964
(208) 376-0453
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-3612
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093844474
BLUE CROSS OF IDAHO
ID
Enumeration date
10/13/2009
Last updated
10/13/2009
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