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General NPI Number Information
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NPI Number | 1174820872
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE MINDWORKS LLC, APRIL KING RUBINO SOLE MBR
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Dates
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Enumeration Date | 02/16/2011
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Last Update Date | 02/16/2011
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Provider Practice Location Address
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Address Line | 803 S JEFFERSON ST SUITE 3
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City | MOSCOW
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State | ID
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Zip | 83843-3096
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Country | US
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Telephone | 208-882-8159
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Fax |
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Provider Business Mailing Address
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Address Line | 803 S JEFFERSON ST SUITE 3
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City | MOSCOW
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State | ID
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Zip | 83843-3096
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Country | US
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Telephone | 208-882-8159
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Fax |
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | MS. APRIL KING RUBINO
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Credential | LPC, CRC, CHT, RYT
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Telephone | 208-882-8159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-4534
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License Number State | ID
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