Individual
ISAAC HEWITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
611 HOOPES AVE, IDAHO FALLS, ID 83401-6106
(208) 206-4525
Mailing address
611 HOOPES AVE, IDAHO FALLS, ID 83401-6106
(208) 206-4525
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-5368
ID
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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