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1275109167
LISA ANNE PERUCCA
IDAHO FALLS, ID
NPI
1275109167
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ID 40790)
Enumeration Date
2021-06-01
Last Update Date
2021-06-01
Business Address
LISA ANNE PERUCCA LMSW
2275 W BROADWAY ST STE G
IDAHO FALLS, ID 83402-2902
Phone number: 208-524-7400
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Mailing Address
LISA ANNE PERUCCA LMSW
2275 W BROADWAY ST STE G
IDAHO FALLS, ID 83402-2902
Phone number: 208-524-7400
Copy
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