Individual
EMILY PORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2105 CORONADO ST, IDAHO FALLS, ID 83404-7495
(208) 534-7881
Mailing address
2105 CORONADO ST, IDAHO FALLS, ID 83404-7495
(208) 534-7881
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LCPC-5352
ID
101YM0800X
Mental Health Counselor
—
—
103TC1900X
Counseling Psychologist
Primary
PSY-1771449
ID
Other
Enumeration date
09/14/2006
Last updated
03/24/2025
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