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Ryan M Ettner, LMSW
Mental Health Counselor in Rathdrum, Idaho
NPI 1356005367

Ryan M Ettner is a Mental Health Counselor based in Rathdrum, ID and is specialized in Mental Health. Ryan M Ettner practices in Rathdrum, ID and has the professional credentials of LMSW. The NPI Number for Ryan M Ettner is 1356005367 and holds a License No. 39709 (Idaho).

The current practice location address for Ryan M Ettner is 14954 N Coeur Dalene St, Rathdrum, ID and can be reached out via phone at 208-687-0538.

Location: 14954 N Coeur Dalene St, Rathdrum, ID, 83858-6484
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1356005367
Provider Name
Ryan M Ettner
Credential
LMSW
Provider Entity Type
Individual
Gender
Male
Address
14954 N Coeur Dalene St, Rathdrum, ID, 83858-6484
Phone Number
208-687-0538
Fax Number
Provider Enumeration Date
10/26/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1437270097 01 ID ALL PRIVATE INS UTILIZED
institution
Provider Business Practice Location Address Details
Address
14954 N Coeur Dalene St
City
Rathdrum
State
Idaho
Zip
83858-6484
Phone Number
208-687-0538
Fax Number
person
Provider Business Mailing Address Details
Address
14954 N Coeur Dalene St
City
Rathdrum
State
Idaho
Zip
83858-6484
Phone Number
208-687-0538
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
39709 (Idaho)
Definition
Definition to come...
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