Peterson, Russell Henry
Peterson, Russell Henry is an individual health care provider with primary practice located at 2375 E Sunnyside Rd Suite C, Idaho Falls ID 83404-8280. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Peterson, Russell Henry can be contacted via phone (208) 529-5777.Contact Information
Primary practice address
2375 E Sunnyside Rd Suite C
Idaho Falls ID 83404-8280
Phone: (208) 529-5777
Fax: (208) 529-5778
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | LCPC-3125 | Idaho |
Profile Details
| NPI number | 1093879637 |
|---|---|
| LBN Legal business name | Peterson, Russell Henry |
| Credentials | M.S. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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