Individual
EMILY HACKWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
343 E 4TH N STE 227, REXBURG, ID 83440-6008
(208) 208-2131
Mailing address
833 SAGE DR, SAINT ANTHONY, ID 83445-5417
(208) 351-4980
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7371149
ID
Other
Enumeration date
02/21/2025
Last updated
02/21/2025
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