Organization
LILAC COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDIE CHRISTINE DEGROAT LPC (BUSINESS OWNER)
(208) 249-0432
Entity
Organization
Contact information
Practice address
824 17TH AVE S STE 11, NAMPA, ID 83651-4781
(208) 249-0432
Mailing address
824 17TH AVE S STE 11, NAMPA, ID 83651-4781
(208) 249-0432
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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