Individual provider · Type 1 NPI

Pamela Fagan, M.A., LCPC

Mental Health Counselor · Boise, ID

NPI number 1104093061 Active

Practice location

13923 W Wainwright Dr Ste 302
Boise, ID 83713-1969

Call (208) 724-8598 Map

Mailing address

13599 W Elmspring St
Boise, ID 83713-1389

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XLCPC-4674 (ID)

Mental Health Counselor: Definition to come...

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About NPI 1104093061

Pamela Fagan, M.A., LCPC's National Provider Identifier is 1104093061, issued on May 9, 2008. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Boise, ID. The record was last updated on Feb 22, 2011.