Individual
MR. MATTHEW D GESKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
834 FALLS AVE, SUITE 1180, TWIN FALLS, ID 83301-3365
(208) 735-0090
(208) 735-0090
Mailing address
834 FALLS AVE, SUITE 1180, TWIN FALLS, ID 83301-3365
(208) 735-0090
(208) 735-0090
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC3196
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010139485
BLUE SHIELD
ID
01
—
Q5449
BLUE CROSS
ID
Enumeration date
10/04/2005
Last updated
07/17/2014
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