Individual
MS. IMELDA DALEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
422 17TH ST, LEWISTON, ID 83501-2526
(208) 743-4680
(208) 743-1756
Mailing address
PO BOX 2145, LEWISTON, ID 83501-1465
(208) 743-4680
(208) 743-1756
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X5937
BLUE CROSS OF IDAHO
ID
Enumeration date
08/29/2005
Last updated
07/09/2007
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