Individual
CAMILLE HARDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, NCC
Contact information
Practice address
1904 JENNIE LEE DR, IDAHO FALLS, ID 83404-6159
(208) 523-1558
Mailing address
1904 JENNIE LEE DR, IDAHO FALLS, ID 83404-6159
(208) 523-1558
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-5943
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC-5943
STATE COUNSELING LICENSE
ID
Enumeration date
08/05/2015
Last updated
05/05/2016
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