Individual
MRS. ANILE NINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
5484 N GARY LANE, BOISE, ID 83714
(208) 371-6702
(208) 501-8548
Mailing address
5484 N GARY LANE, BOISE, ID 83714
(208) 371-6702
(208) 501-8548
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-6859
ID
101YP2500X
Professional Counselor
LPC-5185
ID
Other
Enumeration date
09/25/2013
Last updated
05/11/2020
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