Individual
RISA G. MORTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1759 JACKSON AVE, BURLEY, ID 83318-2128
(208) 431-1889
Mailing address
1759 JACKSON AVE, BURLEY, ID 83318-2128
(208) 431-1889
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC 4877
ID
Other
Enumeration date
06/26/2013
Last updated
11/04/2025
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