Doctor Name: | MRS. WANDA LEE NEWTON |
NPI Number: | 1073672424 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MED |
License Number: | LCPC39 |
Business Practice Address: | 901 Main Street Suite B Caldwell, ID - 83605 |
Business Phone Number: | 2084542471 |
Business Fax Number: | |
Mailing Address: | 901 Main Street, Suite B CALDWELL |
State: | ID |
Postal Code: | 83605 |
Phone Number: | 2084542471 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | LCPC39 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |