Individual
LISA HALSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1115 IRONWOOD DRIVE, COEUR D' ALENE, ID 83814
(208) 819-5951
Mailing address
1115 IRONWOOD DRIVE, COEUR D' ALENE, ID 83814
(208) 819-5951
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-5226
ID
Other
Enumeration date
06/13/2014
Last updated
06/13/2014
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