Individual
MS. AMANDA NICOLE DEYOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1705 W RESSEGUIE ST, BOISE, ID 83702-3934
(208) 861-1051
Mailing address
PO BOX 1014, BOISE, ID 83701-1014
(208) 861-1051
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC-4741
ID
103K00000X
Behavior Analyst
Primary
1-13-14177
—
Other
Enumeration date
04/09/2014
Last updated
04/09/2014
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