Individual
SUSAN NASSER RECORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1323 E SHERMAN AVE, STE D, COEUR D ALENE, ID 83814-4069
(208) 676-1075
Mailing address
3117 N 18TH ST, COEUR D ALENE, ID 83815-6458
(208) 640-6814
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-4090
ID
Other
Enumeration date
06/01/2010
Last updated
06/01/2010
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