Individual
SUSAN MARIE HOLASEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
190 IRONWOOD CENTER DRIVE, COEUR D'ALENE, ID 83814
(208) 765-4509
(208) 665-7014
Mailing address
190 IRONWOOD CENTER DRIVE, COEUR D'ALENE, ID 83814
(208) 765-4509
(208) 665-7014
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-205
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035305
—
ID
Enumeration date
05/11/2007
Last updated
07/14/2008
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