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CAMERON KEITH WIEMERSLAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
161 E MALLARD DR, BOISE, ID 83706-5015
(208) 605-3657
Mailing address
6909 W WESTFIELD PL, BOISE, ID 83704-4651
(208) 914-4645

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-8797
ID

Other

Enumeration date
06/06/2022
Last updated
06/06/2022
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