Individual
PATTI JOLEEN SUMMERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
490 PARK AVE STE 4, IDAHO FALLS, ID 83402-1230
(208) 339-4356
(208) 612-5035
Mailing address
125 COLLEGE ST, IDAHO FALLS, ID 83402-2235
(208) 339-4356
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
COUI-10191
ID
101YP2500X
Professional Counselor
Primary
COUI-10191
ID
Other
Enumeration date
05/22/2025
Last updated
06/05/2025
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