Individual
STEPHANIE WITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
758 W WILDRYE CT, NAMPA, ID 83686-4919
(208) 992-4211
Mailing address
758 W WILDRYE CT, NAMPA, ID 83686-4919
(253) 279-6886
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-9166
ID
101YP2500X
Professional Counselor
LPC-7417
ID
Other
Enumeration date
10/28/2019
Last updated
10/19/2022
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