Individual
SANDRA M COLLANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
703 S AMERICANA BLVD STE 150, BOISE, ID 83702-4976
(757) 769-2954
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
LPC-9594
ID
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
04/25/2023
Last updated
07/05/2023
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