Individual
BERONICA SALAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LCPC
Contact information
Practice address
516 HOLLY ST #304, NAMPA, ID 83686
(208) 467-8836
Mailing address
623 S UNIVERSITY BLVD, NAMPA, ID 83686-5800
(208) 467-8836
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-4637
ID
101YM0800X
Mental Health Counselor
LPC-4098
ID
101YP2500X
Professional Counselor
LPC-4098
ID
Other
Enumeration date
06/15/2010
Last updated
09/28/2020
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