NPI 1841776184

Sussannie Lucynda Da Costa, MSCRCPSYDABD

Practitioner Rehabilitation Counselor Saint Maries, ID

Practice location

Address: 1525 Main Ave, Saint Maries, ID 83861-1216
Phone: (208) 717-1782

Registered specialties

Rehabilitation Counselor Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225C00000X

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Registry record

NPI: 1841776184
Entity type: Individual
Sex (as registered): Female
NPI issued: 18 Jul 2018
Record last updated: 18 Jul 2018

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.