Individual
MR. LANCE MAURICE KINGLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
112 12TH AVE RD, NAMPA, ID 83686-5011
(208) 465-5433
Mailing address
1007 N 12TH ST APT 3, BOISE, ID 83702-4157
(208) 866-8703
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LMSW-35788
ID
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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