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General NPI Number Information
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NPI Number | 1477916542
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Entity Type | Individual
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Provider Name | MATTHEW SATHER B.S
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Gender | Male
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Dates
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Enumeration Date | 04/05/2016
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Last Update Date | 04/05/2016
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Provider Practice Location Address
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Address Line | 1720 N WESTGATE DR
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City | BOISE
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State | ID
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Zip | 83704-7164
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Country | US
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Telephone | 208-334-0808
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Fax |
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Provider Business Mailing Address
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Address Line | 9895 W HOLLANDALE DR
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City | BOISE
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State | ID
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Zip | 83709-2698
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Country | US
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Telephone | 208-921-6667
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 |
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License Number State | ID
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