Jerry Duane Lilly, ED.S Valid NPI
Individual provider · Professional Counselor · Eagle, ID
- NPI
- 1124390786
- Type
- Individual (Type 1)
- Primary specialty
- Professional Counselor (Counselor)
- Specialty group
- Behavioral Health & Social Service Providers
- Taxonomy code
- 101YP2500X
- License number
- LCPC-6990 (ID)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2012-01-29
- Last updated
- 2025-09-11
Practice location
172 S Academy Ave Ste 160
Eagle, ID 83616-6564
(208) 315-4855