Individual
MS. R. RYAN O'ROURKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.C.
Contact information
Practice address
1502 W FRANKLIN ST, NORTH END WELLNESS, BOISE, ID 83702-4028
(208) 371-3671
(208) 344-3059
Mailing address
1502 W FRANKLIN ST, NORTH END WELLNESS, BOISE, ID 83702-4028
(208) 371-3671
(208) 344-3059
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC3651
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010162257
REGENTS BLUE SHIELD
ID
Enumeration date
06/30/2009
Last updated
06/30/2009
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