Individual
KRAIG BOYD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
343 E BONNEVILLE ST, POCATELLO, ID 83201-6434
(208) 233-9135
(208) 233-9136
Mailing address
PO BOX 6249, POCATELLO, ID 83205-6249
(208) 233-9135
(208) 233-9136
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LPC-4409
ID
101YM0800X
Mental Health Counselor
LPC-4409
ID
101YP2500X
Professional Counselor
Primary
LPC-4409
ID
Other
Enumeration date
03/24/2015
Last updated
03/24/2015
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