Individual
MELISSA E FUNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CADC
Contact information
Practice address
1603 12TH AVE RD. SUITE B, NAMPA, ID 83686-8368
(208) 442-0536
Mailing address
3899 N KILBERRY AVE, MERIDIAN, ID 83646-5896
(208) 515-1579
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-7460
ID
Other
Enumeration date
02/11/2020
Last updated
02/11/2020
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