Individual
ANN OMODT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13900 W WAINWRIGHT DR STE 101K, BOISE, ID 83713-5028
(208) 932-4784
Mailing address
13900 W WAINWRIGHT DR STE 101K, BOISE, ID 83713-5028
(208) 932-4784
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/02/2025
Last updated
07/22/2025
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