| NPI | 1972987543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LEE GORRINGE Licensed Practicing Counselor 208-284-8450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: ID LPC-5927) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2015-07-28 |