Individual
DESIREE WADE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
316 N PINE ST, SAINT ANTHONY, ID 83445-5353
(208) 313-0926
Mailing address
316 N PINE ST, SAINT ANTHONY, ID 83445-5353
(208) 313-0926
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-5893
ID
Other
Enumeration date
09/21/2015
Last updated
06/04/2024
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