Individual
ADISSON D ROYLANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8050 W RIFLEMAN ST STE 100, BOISE, ID 83704-9006
(208) 985-3052
Mailing address
8050 W RIFLEMAN ST STE 100, BOISE, ID 83704-9006
(208) 985-3052
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-10523
ID
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
06/10/2021
Last updated
07/14/2024
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