Individual
MADELINE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7684 S COLE RD, BOISE, ID 83709-7229
(208) 917-2161
Mailing address
7684 S COLE RD, BOISE, ID 83709-7229
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-8891
ID
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
07/16/2022
Last updated
11/27/2023
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