Organization
COUNSELING & TREATMENT CENTER OF IDAHO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC FERNELIUS LCSW (OWNER)
(801) 510-4750
Entity
Organization
Contact information
Practice address
339 E 7TH N, REXBURG, ID 83440-5124
(801) 510-4750
Mailing address
339 E 7TH N, REXBURG, ID 83440-5124
(801) 510-4750
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/05/2022
Last updated
05/05/2022
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