Individual
TYLER DANIEL LOBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, NCC, LCPC
Contact information
Practice address
703 S AMERICANA BLVD, BOISE, ID 83702-5099
(208) 706-6375
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6960
ID
101YM0800X
Mental Health Counselor
Primary
LCPC-7961
ID
Other
Enumeration date
06/19/2018
Last updated
12/04/2023
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