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Individual

MRS. RENELLE LASHAE BRUBAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
320 11TH AVE S STE 204, NAMPA, ID 83651-5074
(775) 388-7311
Mailing address
1750 S LINDER RD UNIT E202, MERIDIAN, ID 83642-7396
(775) 388-7311

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-7925
ID

Other

Enumeration date
11/04/2020
Last updated
11/04/2020
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