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Individual

SARAH COLEEN MALLARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.C.C., L.P.C.

Contact information

Practice address
112 12TH AVE RD, NAMPA, ID 83686-5011
(208) 465-5433
(208) 466-5802
Mailing address
112 12TH AVE RD, NAMPA, ID 83686-5011
(208) 465-5433
(208) 466-5802

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-5300
ID

Other

Enumeration date
08/13/2013
Last updated
08/13/2013
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