Individual
CHARMAINE CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2399 S ORCHARD ST STE 201, BOISE, ID 83705-3795
(208) 869-6196
Mailing address
2399 S ORCHARD ST STE 201, BOISE, ID 83705-3795
(208) 899-3693
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-5062
ID
Other
Enumeration date
07/06/2014
Last updated
07/06/2014
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