Individual
AMANDA MAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2055 GARRETT WAY, STE 1, POCATELLO, ID 83201-5100
(208) 233-7832
Mailing address
PO BOX 4908, POCATELLO, ID 83205-4908
(208) 233-7832
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/29/2011
Last updated
03/29/2011
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