Individual
MRS. BETTY J MAGNUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
15798 N RIMROCK RD, HAYDEN LAKE, ID 83835-7336
(208) 772-5360
Mailing address
15798 N RIMROCK RD, HAYDEN LAKE, ID 83835-7336
(208) 772-5360
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2910
ID
Other
Enumeration date
08/26/2010
Last updated
08/26/2010
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