MAI LE PROVENCIO

BOISE, ID
NPI1821534017
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ID  LCSW-34323)
Enumeration Date2017-01-11
Last Update Date2024-10-23
Business Address
MAI LE PROVENCIO LCSW
7235 W POTOMAC DR STE 220
BOISE, ID 83704-9133
Phone number: 208-794-9703
Mailing Address
MAI LE PROVENCIO LCSW
7235 W POTOMAC DR STE 220
BOISE, ID 83704-9133
Phone number: 208-576-0571
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