RUSSELL HENRY PETERSON

IDAHO FALLS, ID
NPI1093879637
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: ID  LCPC-3125)
Enumeration Date2006-12-20
Last Update Date2007-07-08
Business Address
Mr. RUSSELL HENRY PETERSON M.S.
2375 E SUNNYSIDE RD SUITE C
IDAHO FALLS, ID 83404-8280
Phone number: 208-529-5777
Mailing Address
Mr. RUSSELL HENRY PETERSON M.S.
4360 E 278 N
RIGBY, ID 83442-5892
Phone number: 208-359-4775
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