Individual
TONYA KATHRYN HAUSTVEIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
3288 E PINE AVE, MERIDIAN, ID 83642-5922
(208) 888-8886
Mailing address
2214 E JULIET CT, MERIDIAN, ID 83642-1951
(208) 870-0910
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
4863
ID
Other
Enumeration date
03/18/2013
Last updated
03/18/2013
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