Individual
JENNIFER BURLAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
1720 N WESTGATE DR STE A1, BOISE, ID 83704-7164
(208) 334-0969
Mailing address
2613 N 28TH ST, BOISE, ID 83703-5415
(208) 867-1856
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT-4810
ID
Other
Enumeration date
03/23/2016
Last updated
03/23/2016
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