Individual
SALLY ANDERSON CLEARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
190 W. MAIN ST., KUNA, ID 83634
(208) 922-9001
(208) 922-3778
Mailing address
PO BOX 959, KUNA, ID 83634-0900
(208) 922-9001
(208) 922-3778
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-3200
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
806162000
—
ID
Enumeration date
08/28/2007
Last updated
08/28/2007
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