Individual
SAMUEL PHILLIP LUQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC,
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706
(208) 367-2121
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-6180
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-3615
ID
Other
Enumeration date
08/05/2007
Last updated
05/16/2023
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