Individual
EVELYN LEAH WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1015 CALDWELL BLVD STE 5, NAMPA, ID 83651-1717
(208) 614-3070
Mailing address
3206 STARLIGHT AVE, CALDWELL, ID 83605-6625
(208) 614-3070
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-9029
ID
Other
Enumeration date
07/20/2022
Last updated
07/20/2022
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