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1346814639
SHAYLA NICOLE DEVISSER
BOISE, ID
NPI
1346814639
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LCSW-44697)
Enumeration Date
2021-05-19
Last Update Date
2024-03-11
Business Address
SHAYLA NICOLE DEVISSER LCSW-44697
6126 W. STATE STREET
BOISE, ID 83703
Phone number: 208-477-1202
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Mailing Address
SHAYLA NICOLE DEVISSER LCSW-44697
6126 W. STATE STREET
BOISE, ID 83703-0932
Phone number: 208-477-1202
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