Individual
JESSE ALTSULER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6852 W SILVERADO ST, RATHDRUM, ID 83858-8192
(208) 771-1466
Mailing address
6852 W SILVERADO ST, RATHDRUM, ID 83858-8192
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-5047
ID
Other
Enumeration date
09/07/2012
Last updated
09/07/2012
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