LYLENA MARIE SELF

BOISE, ID
NPI1295093789
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
(Licence: ID  LCSW30738)
Enumeration Date2012-05-02
Last Update Date2012-05-02
Business Address
-- LYLENA MARIE SELF LCSW
1720 N WESTGATE DR STE 1A
BOISE, ID 83704-7164
Phone number: 208-334-6938
Mailing Address
-- LYLENA MARIE SELF LCSW
1720 N WESTGATE DR STE 1A
BOISE, ID 83704-7164
Phone number: 208-334-6938
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