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
Phone: (208) 605-3663
Fax: (208) 605-3663
Website:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1881157949 | NPPES |
Idaho | MEDICAID | 1 |
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