Individual
DAVID PETERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
720 EAST ALICE, BLACKFOOT, ID 83221
(208) 782-9874
Mailing address
PO BOX 129, BLACKFOOT, ID 83221-0129
(208) 782-9874
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT-2978
ID
Other
Enumeration date
05/01/2019
Last updated
05/01/2019
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