Individual
MARISA ARIEL AYALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
123 N YALE ST, NAMPA, ID 83651-2340
(208) 585-3375
Mailing address
1999 E WILSON LN APT C, MERIDIAN, ID 83642-2378
(443) 538-2426
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-6966
ID
Other
Enumeration date
06/24/2020
Last updated
06/24/2020
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