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General NPI Number Information
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NPI Number | 1528027182
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Entity Type | Individual
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Provider Name | VICTOR WAYNE DURNIL LCPC
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Gender | Male
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1250 W CHERRY LN
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City | MERIDIAN
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State | ID
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Zip | 83642-1514
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Country | US
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Telephone | 208-887-1911
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Fax | 208-895-8049
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Provider Business Mailing Address
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Address Line | 216 N 19TH ST
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City | BOISE
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State | ID
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Zip | 83702-4932
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Country | US
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Telephone | 208-921-6544
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Fax | 208-395-8049
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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 | LCPC3397
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License Number State | ID
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