Individual
JAMES RESARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2100 NIAGARA ST, IDAHO FALLS, ID 83404-8025
(208) 542-9919
Mailing address
2100 NIAGRA ST, IDAHO FALLS, ID 83404
(208) 542-9919
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
101YS0200X
School Counselor
—
—
Other
Enumeration date
02/27/2013
Last updated
02/27/2013
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