JUSTIN HIROSHI HIRASAKI

GOODING, ID
NPI1902286099
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID  10267)
Enumeration Date2015-06-03
Last Update Date2015-06-03
Business Address
-- JUSTIN HIROSHI HIRASAKI
605 11TH AVE E
GOODING, ID 83330-5368
Phone number: 208-934-8461
Mailing Address
-- JUSTIN HIROSHI HIRASAKI
842 JEFFERSON ST
MONTPELIER, ID 83254-1452
Phone number: 808-277-8075
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