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General NPI Number Information
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NPI Number | 1972237311
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Entity Type | Individual
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Provider Name | REBEKAH LYNN KETURAH COTNER MSW, LSWAIC/LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/12/2022
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Last Update Date | 09/15/2025
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Provider Practice Location Address
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Address Line | 2273 S VISTA AVE STE 190
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City | BOISE
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State | ID
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Zip | 83705-7341
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Country | US
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Telephone | 208-343-2737
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Fax | 208-342-3238
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Provider Business Mailing Address
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Address Line | 2589 S FIVE MILE RD
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City | BOISE
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State | ID
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Zip | 83709-2325
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Country | US
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Telephone | 208-254-1027
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 61523960
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-45371
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License Number State | ID
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