| Misty Mountains Therapy, Llc | |
|
534 Trejo St # 200j Rexburg ID 83440-5408 | |
| (530) 949-4774 | |
| (219) 200-3367 |
| Full Name | Misty Mountains Therapy, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 534 Trejo St # 200j, Rexburg, Idaho |
| Authorized Official Name and Position | Jefferson Hunt (OWNER) |
| Authorized Official Contact | 6306325822 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Misty Mountains Therapy, Llc 534 Trejo St # 200j Rexburg ID 83440-5408 Ph: (630) 632-5822 | Misty Mountains Therapy, Llc 534 Trejo St # 200j Rexburg ID 83440-5408 Ph: (530) 949-4774 |
| NPI Number | 1841934809 |
|---|---|
| Provider Enumeration Date | 04/26/2022 |
| Last Update Date | 04/26/2022 |
| Certification Date | 04/26/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841934809 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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