Individual
CHRISTINE M IVIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC - 815
Contact information
Practice address
41 NORTHRIDGE WAY, JEROME, ID 83338-6200
(208) 871-7749
Mailing address
41 NORTHRIDGE WAY, JEROME, ID 83338-6200
(208) 871-7749
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC-815
ID
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
101YS0200X
School Counselor
—
—
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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