Individual
KIRSTEN ELISE COSTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
318 E MAIN ST, GRANGEVILLE, ID 83530-2238
(208) 500-2066
Mailing address
PO BOX 312, LUCILE, ID 83542-0312
(208) 500-2066
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5871087
ID
101YP2500X
Professional Counselor
5871087
ID
Other
Enumeration date
01/01/2026
Last updated
01/01/2026
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