Individual
MS. RIT LARAE NAUMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
3330 HIGHWAY 30 W, POCATELLO, ID 83201-6001
(208) 234-9100
(208) 234-9104
Mailing address
2625 S FAIRWAY DR, POCATELLO, ID 83201-2374
(208) 237-2166
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
2939
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010150906
REGENCE BLUE SHIELD
ID
01
—
Q6611
BLUE CROSS OF IDAHO
ID
Enumeration date
11/15/2006
Last updated
07/09/2007
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