O'Leary, Rusty

O'Leary, Rusty is an individual health care provider with primary practice located at 1305 2Nd St S Suite 201, Nampa ID 83651-3944. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. O'Leary, Rusty can be contacted via phone (208) 463-0202.

Contact Information

Primary practice address
1305 2Nd St S Suite 201 Nampa ID 83651-3944
Phone: (208) 463-0202
Fax: (208) 463-0205
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LCPC-296 Idaho

Profile Details

NPI number 1215155973
LBN Legal business name O'Leary, Rusty
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2007
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215155973 NPPES
Idaho Other LCPC-296 ID PROFESSIONAL LICENSE

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