Organization · Type 2 NPI
Thomas R Van Fossen
Mental Health Counselor · Coeur D Alene, ID
NPI number
1730496035
Active
Practice location
5431 N Government Way # B
Coeur D Alene, ID 83815-5073
Fax (208) 667-7609
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor Primary | 101YM0800X | None listed |
Mental Health Counselor: Definition to come...
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About NPI 1730496035
Thomas R Van Fossen's National Provider Identifier is 1730496035, issued on Sep 8, 2010. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Coeur D Alene, ID. The record was last updated on Nov 10, 2010.