Individual
AMMON HOPKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
416 6TH ST, WALLACE, ID 83873-2219
(208) 556-0960
Mailing address
416 6TH ST, WALLACE, ID 83873-2219
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LMSW-31939
ID
Other
Enumeration date
12/12/2013
Last updated
12/12/2013
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