Megorden, Lacey

Megorden, Lacey is an sole proprietor health care provider with primary practice located at 4222 W Emerald St , Boise ID 83706-2037. She recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as her primary health care specialty. Megorden, Lacey can be contacted via phone (208) 605-3663.

Contact Information

Primary practice address
4222 W Emerald St Boise ID 83706-2037
Fax: (208) 605-3663
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X Idaho

Profile Details

NPI number 1881157949
LBN Legal business name Megorden, Lacey
Credentials BS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 7th, 2019
Last updated Apr 7th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881157949 NPPES
Idaho MEDICAID 1

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