Individual
CLARYCE MANWEILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 N BENJAMIN LN STE 201, BOISE, ID 83704-5094
(208) 287-5628
(208) 287-5609
Mailing address
400 N BENJAMIN LN STE 201, BOISE, ID 83704-5094
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
12/06/2013
Last updated
05/01/2020
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