Individual
MARY LOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
6300 W DENTON ST, BOISE, ID 83704-9326
(208) 577-4870
Mailing address
595 W WARREN ST, BOISE, ID 83706-3959
(208) 353-2654
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-7592
ID
101YP2500X
Professional Counselor
—
ID
Other
Enumeration date
04/30/2020
Last updated
03/19/2024
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