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General NPI Number Information
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NPI Number | 1396399952
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Entity Type | Organization
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Legal Business Name | WAYNE COUNSELING, LLC
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Dates
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Enumeration Date | 07/31/2019
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Last Update Date | 02/19/2021
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Provider Practice Location Address
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Address Line | 800 W MAIN ST STE 1460
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City | BOISE
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State | ID
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Zip | 83702-5983
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Country | US
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Telephone | 208-371-7213
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 508
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City | KUNA
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State | ID
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Zip | 83634-0508
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Country | US
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Telephone | 208-202-4025
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DANIELLE WAYNE
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Credential |
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Telephone | 208-371-7213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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