PAMELA FAGAN

BOISE, ID
NPI1104093061
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: ID  LCPC-4674)
Enumeration Date2008-05-09
Last Update Date2011-02-22
Business Address
-- PAMELA FAGAN M.A., LCPC
13923 W WAINWRIGHT DR STE 302
BOISE, ID 83713-1969
Phone number: 208-724-8598
Mailing Address
-- PAMELA FAGAN M.A., LCPC
13599 W ELMSPRING ST
BOISE, ID 83713-1389
Phone number: 208-724-8598
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