Individual
MR. RUSTY JAMES WATTIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW, ADC
Contact information
Practice address
709 DEARBORN ST, CALDWELL, ID 83605-4116
(208) 606-9494
Mailing address
709 DEARBORN ST, CALDWELL, ID 83605-4116
(208) 606-9494
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
ID
104100000X
Social Worker
Primary
3581715
ID
Other
Enumeration date
07/08/2024
Last updated
06/11/2026
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