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1104305515
LISA M BROKAW
MERIDIAN, ID
NPI
1104305515
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: ID LPC-6942)
Enumeration Date
2018-08-08
Last Update Date
2018-08-08
Business Address
LISA M BROKAW LPC, NCC
2176 E FRANKLIN RD STE 100
MERIDIAN, ID 83642-8009
Phone number: 208-515-7661
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Mailing Address
LISA M BROKAW LPC, NCC
477 N STEAR AVE
KUNA, ID 83634-5004
Phone number: 208-570-0503
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