Individual
MIKAYLA FORREST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1015 CALDWELL BLVD, NAMPA, ID 83651-1717
(208) 353-4173
Mailing address
712 9TH AVE S, NAMPA, ID 83651-4540
(208) 353-4173
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5388
ID
Other
Enumeration date
05/06/2009
Last updated
05/16/2014
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