Individual
TREVA RAE RAWLINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
7174 MAIN ST., SUITE A, BONNERS FERRY, ID 83805-8740
(208) 267-0936
(208) 267-0936
Mailing address
PO BOX 1235, 7174 MAIN ST. SUITE A, BONNERS FERRY, ID 83805-8740
(208) 946-1386
(208) 267-0936
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-4714
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCPC-4714
STATE LICENSE
ID
Enumeration date
03/29/2011
Last updated
07/14/2011
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