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General NPI Number Information
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NPI Number | 1962883348
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Entity Type | Individual
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Provider Name | PATRICIA BLAHA LCPC
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Gender | Female
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Dates
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Enumeration Date | 06/11/2015
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Last Update Date | 12/04/2023
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Provider Practice Location Address
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Address Line | 3350 W AMERICANA TER STE 320
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City | BOISE
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State | ID
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Zip | 83706-2548
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Country | US
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Telephone | 208-867-1383
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6796
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City | BOISE
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State | ID
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Zip | 83707-0796
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Country | US
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Telephone | 208-867-1383
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Fax | 208-207-2870
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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 | LPC5837
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License Number State | ID
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