EMILY DIANE BERGSTROM

BOISE, ID
NPI1184254146
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: ID  LPC-6167)
Enumeration Date2020-01-18
Last Update Date2020-01-18
Business Address
EMILY DIANE BERGSTROM LPC
2365 N 34TH ST
BOISE, ID 83703-5523
Phone number: 208-473-8205
Mailing Address
EMILY DIANE BERGSTROM LPC
2365 N 34TH ST
BOISE, ID 83703-5523
Phone number: 208-473-8205
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