Individual
MRS. KRISTA JOY LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1910 UNIVERSITY DR, BOISE, ID 83725-5047
(208) 426-2869
Mailing address
2691 NW 13TH ST, MERIDIAN, ID 83646-3102
(208) 420-5918
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC 4906
ID
Other
Enumeration date
10/01/2009
Last updated
01/09/2013
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