person
Jerry Duane Lilly, EDS
Professional Counselor in Eagle, Idaho
NPI 1124390786

Jerry Duane Lilly is a Professional Counselor based in Boise, ID and is specialized in Professional. Jerry Duane Lilly practices in Eagle, ID and has the professional credentials of EDS. The NPI Number for Jerry Duane Lilly is 1124390786 and holds a License No. LCPC-6990 (Idaho).

The current practice location address for Jerry Duane Lilly is 172 S Academy Ave Ste 160, Eagle, ID and can be reached out via phone at 208-315-4855. You can also correspond with Jerry Duane Lilly through the mailing address at 12073 N HUMPHREYS WAY, BOISE, ID - 83714-9343 (mailing address contact number: 208-315-4855).

Location: 172 S Academy Ave Ste 160, Eagle, ID, 83714-9343
person
Provider Profile Details
NPI Number
1124390786
Provider Name
Jerry Duane Lilly
Credential
EDS
Provider Entity Type
Individual
Gender
Male
Address
172 S Academy Ave Ste 160, Eagle, ID, 83714-9343
Phone Number
208-315-4855
Fax Number
Provider Enumeration Date
01/29/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
172 S Academy Ave Ste 160
City
State
Zip
83616-6564
Phone Number
208-315-4855
Fax Number
person
Provider Business Mailing Address Details
Address
172 S Academy Ave Ste 160
City
State
Zip
83616-6564
Phone Number
208-315-4855
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
License No.
LCPC-6990 (Idaho)
Definition
Definition to come...
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