Individual
MELISSA DIANE PFENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., LCPC
Contact information
Practice address
1616 E SELTICE WAY STE 213, POST FALLS, ID 83835-0000
(208) 699-0679
Mailing address
PO BOX 3620, POST FALLS, ID 83877-0018
(208) 699-0679
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC 4662
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCPC 4662
STATE OF IDAHO LICENSING BOARD
ID
Enumeration date
03/02/2010
Last updated
08/05/2011
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