Individual
ANGELA ELLEN DALLOLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
6550 W EMERALD ST STE 108, BOISE, ID 83704-8780
(208) 342-6300
(208) 342-6301
Mailing address
13 E ADA AVE, MERIDIAN, ID 83642-2725
(208) 342-6300
(208) 342-6301
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW-37336
ID
Other
Enumeration date
03/05/2015
Last updated
04/09/2018
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