Individual
MADDISON VINCENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4405 E FLAMINGO AVE, NAMPA, ID 83687-3113
(208) 899-4042
Mailing address
13768 S GREYBULL ST, NAMPA, ID 83651-5087
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-6093
ID
Other
Enumeration date
02/29/2016
Last updated
02/29/2016
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