Individual
MRS. JAMIE K LANGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
760 E WARM SPRINGS AVE STE F, BOISE, ID 83712-6459
(208) 447-7368
Mailing address
5103 N WILDRYE DR, BOISE, ID 83703-3823
(208) 447-7368
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC-6579
ID
101YP2500X
Professional Counselor
Primary
LPC-6579
ID
Other
Enumeration date
07/17/2017
Last updated
07/17/2017
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