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1205978095
CAROL PANGBURN
EAGLE, ID
NPI
1205978095
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ID LCPC 168)
Enumeration Date
2007-02-12
Last Update Date
2008-01-13
Business Address
-- CAROL PANGBURN
3042 S WHITEPOST WAY
EAGLE, ID 83616-6461
Phone number: 208-939-7514
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Mailing Address
-- CAROL PANGBURN
3042 S WHITEPOST WAY
EAGLE, ID 83616-6461
Phone number: 208-939-7514
Copy
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