Individual
MIKAYLA ELIZABETH RIRIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
8918 W NORTHVIEW ST, BOISE, ID 83704-7017
(208) 421-6612
Mailing address
8918 W NORTHVIEW ST, BOISE, ID 83704-7017
(208) 421-6612
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
LPC-9497
ID
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
11/10/2020
Last updated
05/12/2023
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