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1750615167
KRISTA JOY LANE
BOISE, ID
NPI
1750615167
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: ID LCPC 4906)
Enumeration Date
2009-10-01
Last Update Date
2013-01-09
Business Address
Mrs. KRISTA JOY LANE LCPC
1910 UNIVERSITY DR
BOISE, ID 83725-5047
Phone number: 208-426-2869
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Mailing Address
Mrs. KRISTA JOY LANE LCPC
2691 NW 13TH ST
MERIDIAN, ID 83646-3102
Phone number: 208-420-5918
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