Individual
JILL KUISTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
202 E ANTON AVE, 206, COEUR D ALENE, ID 83815-3727
(208) 667-6095
Mailing address
202 E ANTON AVE, 206, COEUR D ALENE, ID 83815-3727
(208) 667-6095
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW31280
ID
Other
Enumeration date
09/25/2012
Last updated
09/25/2012
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