Individual
MR. DANIEL JACOB ROTHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
220 RIVER ST E, SUITE D, KETCHUM, ID 83340
(208) 471-4838
Mailing address
PO BOX 533, KETCHUM, ID 83340
(208) 471-4838
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7227
LCPC
ID
Enumeration date
03/12/2015
Last updated
01/10/2020
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