Individual
CAMI FELLOWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
75 S 1ST W, PRESTON, ID 83263-1204
(208) 852-2370
(208) 852-5570
Mailing address
75 S 1ST W, PRESTON, ID 83263-1204
(208) 852-2370
(208) 852-5570
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
12/11/2014
Last updated
12/11/2014
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