| NPI | 1871654798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY KELSHAW Counselor 208-478-4642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID LCPC-2812) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2020-08-22 |