Organization
RIVERWOOD COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATTY BULLICK (OWNER)
(208) 765-4795
Entity
Organization
Contact information
Practice address
2003 KOOTENAI HEALTH WAY, STE 310, COEUR D ALENE, ID 83814-6051
(208) 765-4795
(208) 765-2903
Mailing address
PO BOX 478, COEUR D ALENE, ID 83816-0478
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807261800
—
ID
Enumeration date
07/25/2006
Last updated
07/26/2012
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