Individual
LAVELLE SACHI GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
112 12TH AVE RD, NAMPA, ID 83686-5011
(208) 465-5433
Mailing address
112 12TH AVE RD, NAMPA, ID 83686-5011
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-3782
ID
Other
Enumeration date
02/05/2009
Last updated
07/07/2023
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