Individual
ROSALINDA CRUZ BOURASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2265 W BROADWAY ST, IDAHO FALLS, ID 83402-2996
(208) 524-7400
Mailing address
535 MARIAH AVE APT 4303, REXBURG, ID 83440-2694
(208) 707-3314
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5371745
ID
Other
Enumeration date
01/14/2025
Last updated
01/14/2025
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