Individual
MAKENNA STOLP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
161 E MALLARD DR, BOISE, ID 83706-5015
(208) 203-2781
Mailing address
161 E MALLARD DR, BOISE, ID 83706-5015
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-8781
ID
Other
Enumeration date
05/23/2022
Last updated
05/23/2022
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