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Individual

RYAN LIPSCOMB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S. LPC

Contact information

Practice address
1880 JUDITH LN, BOISE, ID 83705-3119
(208) 367-6910
(208) 367-6170
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5171
(208) 367-5180

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-4642
ID

Other

Enumeration date
03/14/2011
Last updated
03/14/2011
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