Individual
DR. BOBBIE ANN BIRDSALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., LCPC
Contact information
Practice address
2211 S SCYENE WAY, BOISE, ID 83712-8532
(208) 859-9663
Mailing address
2211 S SCYENE WAY, BOISE, ID 83712-8532
(208) 859-9663
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPCS-264
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCPC-264
IDAHO
ID
Enumeration date
04/09/2021
Last updated
04/09/2021
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