Individual
MRS. HEATHER SUE TUSTISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
2176 E FRANKLIN RD STE 100, MERIDIAN, ID 83642-8009
(208) 869-0199
(208) 908-6164
Mailing address
2176 E FRANKLIN RD STE 100, MERIDIAN, ID 83642-8009
(208) 869-0199
(208) 908-6164
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LCPC-4258
ID
101YM0800X
Mental Health Counselor
LCPC-4258
ID
101YP1600X
Pastoral Counselor
LCPC-4258
ID
101YP2500X
Professional Counselor
Primary
LCPC-4258
ID
Other
Enumeration date
03/13/2007
Last updated
05/07/2020
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