Individual
MRS. MATINA BOLSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1200 W IRONWOOD DR, COEUR D ALENE, ID 83814-2660
(208) 664-9729
Mailing address
1200 W IRONWOOD DR, COEUR D ALENE, ID 83814-2660
(208) 664-9729
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-6045
ID
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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