Organization
BOURNER COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MEGAN BOURNER LPC (OWNER)
(208) 739-0230
Entity
Organization
Contact information
Practice address
100 S IOWA AVE, FRUITLAND, ID 83619-2644
(208) 453-4378
(208) 452-4378
Mailing address
100 S IOWA AVE, FRUITLAND, ID 83619-2644
(208) 453-4378
(208) 452-4378
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC5147
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ID3857
STATE OF IDAHO
ID
Enumeration date
10/14/2014
Last updated
10/14/2014
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