Individual
ISSA NTAKARUTIMANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
500 W BANNOCK ST, BOISE, ID 83702-5916
(208) 598-8442
Mailing address
205 S BRUCE LN, BOISE, ID 83712-7804
(208) 906-5878
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
ID
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
02/18/2021
Last updated
05/18/2025
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