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Individual

NICHOLAS PACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1101 E POLSTON AVE STE A, POST FALLS, ID 83854-6045
(208) 981-0431
Mailing address
1121 E BOYD AVE APT A, COEUR D ALENE, ID 83814-4384

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LAMFT-8468
ID
106H00000X
Marriage & Family Therapist
Primary
ID

Other

Enumeration date
02/03/2022
Last updated
06/17/2024
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