Individual
AMANDA JO MINOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
409 WASHINGTON AVE, POCATELLO, ID 83201-4520
(208) 234-2646
(208) 232-0035
Mailing address
409 WASHINGTON AVE, POCATELLO, ID 83201-4520
(208) 234-2646
(208) 232-0035
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-4530
ID
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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