Individual
YESSICA MENDOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7025 W EMERALD ST, BOISE, ID 83704-8657
(208) 947-0863
(208) 672-0324
Mailing address
7025 W EMERALD ST, BOISE, ID 83704-8657
(208) 947-0863
(208) 672-0324
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-7788
ID
Other
Enumeration date
08/21/2020
Last updated
08/21/2020
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