| Luminous Wisdom Sandplay Therapy And Counseling Pllc | |
|
250 S Skyline Dr Ste 3 Idaho Falls ID 83402-3294 | |
| (208) 243-9152 | |
| (888) 240-1846 |
| Full Name | Luminous Wisdom Sandplay Therapy And Counseling Pllc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 250 S Skyline Dr Ste 3, Idaho Falls, Idaho |
| Authorized Official Name and Position | Michele Marie Elsbree (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2082439152 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Luminous Wisdom Sandplay Therapy And Counseling Pllc 2235 E 25th St Ste 140 Idaho Falls ID 83404-8090 Ph: (208) 243-9152 | Luminous Wisdom Sandplay Therapy And Counseling Pllc 250 S Skyline Dr Ste 3 Idaho Falls ID 83402-3294 Ph: (208) 243-9152 |
| NPI Number | 1508636770 |
|---|---|
| Provider Enumeration Date | 01/08/2024 |
| Last Update Date | 10/01/2024 |
| Certification Date | 10/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508636770 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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