LILLY BWANGA
Individual Provider (NPI-1)
Active
Community/Behavioral Health
Provider Information
- NPI Number
1225723620- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 8620 W EMERALD ST STE 150, BOISE, ID, 837044839
- Phone
- (208) 617-3265
Specialties & Taxonomies
Community/Behavioral Health
Primary License: ID