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1174196299
AVALON NOEL TAYLOR DERLACKI PRENTISS
BOISE, ID
NPI
1174196299
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ID 8188)
Enumeration Date
2021-07-19
Last Update Date
2024-11-19
Business Address
AVALON NOEL TAYLOR DERLACKI PRENTISS LPC
1015 W HAYS ST STE 102
BOISE, ID 83702-5412
Phone number: 208-207-8889
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Mailing Address
AVALON NOEL TAYLOR DERLACKI PRENTISS LPC
1015 W HAYS ST STE 102
BOISE, ID 83702-5412
Phone number:
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