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Individual

KATIE SUDHALTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
10448 W GARVERDALE CT STE 606, BOISE, ID 83704-5474
(303) 704-1901
Mailing address
645 E HOLLY ST APT 106, BOISE, ID 83712-7884
(303) 704-1901

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
COUI-10543
ID
101YM0800X
Mental Health Counselor
ID

Other

Enumeration date
08/20/2024
Last updated
08/20/2024
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