Organization
MELISSA RUTH LCPC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA RUTH LCPC (OWNER)
(208) 841-1704
Entity
Organization
Contact information
Practice address
1015 W HAYS ST STE 207, BOISE, ID 83702-5424
(208) 918-0319
Mailing address
910 E WASHINGTON ST, BOISE, ID 83712-7321
(208) 841-1704
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/26/2018
Last updated
02/26/2018
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