Summit Creek Counseling LLC
NPI #1609415199 in Malad City, Idaho
Provider Information
- NPI Number
- 1609415199
- Entity Type
- Organization
- Organization Name
- Summit Creek Counseling LLC
- Primary Specialty
- Counselor
- Enumeration Date
- Dec 31, 2019
- Last Updated
- Dec 31, 2019
Practice Location
- Address
- 57 BANNOCK ST
- City
- Malad City
- State
- Idaho
- ZIP Code
- 83252-1240
- Phone
- (208) 220-6534
Authorized Official
- Name
- JODIE BARNES, LPC
- Title
- MANAGER/MEMBER
- Phone
- (208) 220-6534
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor |
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