Individual
TRISTA MANON KOVACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
900 N. LIBERTY STREET, SUITE# 204, BOISE, ID 83704
(208) 367-7380
Mailing address
900 N. LIBERTY STREET, SUITE# 204, BOISE, ID 83704
(208) 367-7380
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-7205
ID
101YP2500X
Professional Counselor
LPC-3544
ID
Other
Enumeration date
05/04/2007
Last updated
03/25/2019
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