Individual
MRS. TAMRA SUSANNE VANEGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, MAC
Contact information
Practice address
3023 E COPPER POINT DR STE 205, MERIDIAN, ID 83642-9290
(208) 343-7797
Mailing address
14144 W BATTENBERG CT, BOISE, ID 83713-1241
(208) 938-0988
(208) 323-0775
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-3149
ID
Other
Enumeration date
03/12/2010
Last updated
03/12/2010
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