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Individual

MICHELLE MARCHANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2705 E 17TH ST, AMMON, ID 83406-6601
(208) 346-7500
Mailing address
2705 E 17TH ST, AMMON, ID 83406-6601
(208) 346-7500

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-6560
ID

Other

Enumeration date
02/15/2018
Last updated
02/15/2018
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Product
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