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General NPI Number Information
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NPI Number | 1003434887
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Entity Type | Individual
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Provider Name | MARY CLAIRE FERY LPC
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Gender | Female
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Dates
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Enumeration Date | 07/08/2020
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Last Update Date | 03/22/2022
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Provider Practice Location Address
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Address Line | 410 S ORCHARD ST STE 128
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City | BOISE
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State | ID
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Zip | 83705-1288
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Country | US
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Telephone | 208-918-1283
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Fax |
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Provider Business Mailing Address
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Address Line | 4081 W QUAIL RIDGE DR
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City | BOISE
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State | ID
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Zip | 83703-3851
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Country | US
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Telephone | 605-321-4593
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-7702
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License Number State | ID
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