Individual
ANN JOLENE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.C.P.C.
Contact information
Practice address
4696 W OVERLAND RD, SUITE 118, BOISE, ID 83705-2845
(208) 841-3581
(208) 906-8572
Mailing address
4696 W OVERLAND RD, SUITE 118, BOISE, ID 83705-2845
(208) 841-3581
(208) 906-8572
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-3938
ID
Other
Enumeration date
01/14/2008
Last updated
04/02/2013
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