Individual
ISABELLA RAQUEL ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1335 S 5TH AVE APT 108, POCATELLO, ID 83201-6709
(505) 363-0727
Mailing address
3852 N EAGLE RD, BOISE, ID 83713-0750
(208) 378-0014
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3571869
ID
Other
Enumeration date
07/08/2025
Last updated
07/08/2025
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