Individual
AMANDA MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
855 N CAPITAL AVE STE 1, IDAHO FALLS, ID 83402-3405
(208) 552-0855
Mailing address
2195 LOGAN DR, IDAHO FALLS, ID 83401-4404
(208) 357-8909
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
10116
ID
Other
Enumeration date
01/12/2024
Last updated
01/12/2024
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