Organization
FULL DISCLOSURE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE M RODIN LMFT (OWNER)
(310) 570-6897
Entity
Organization
Contact information
Practice address
172 S ACADEMY AVE STE 150, EAGLE, ID 83616-6564
(208) 668-2701
Mailing address
238 S NESKOWIN WAY, EAGLE, ID 83616-4964
(310) 570-6897
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
10/17/2024
Last updated
10/17/2024
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