Organization
WELLNESS COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE MATHIS LPC (OWNER)
(208) 230-4461
Entity
Organization
Contact information
Practice address
6932 S HUNT WAY, BOISE, ID 83709-1564
(208) 230-4461
Mailing address
10673 W LAKE HAZEL RD # 50, BOISE, ID 83709-5453
(208) 230-4461
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
12/28/2023
Last updated
12/28/2023
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