Individual
YURI DAVYDOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
125 S SAMSON TRL, MCCALL, ID 83638-5187
(208) 830-8520
Mailing address
344 RIO VISTA BLVD, MCCALL, ID 83638-4302
(208) 830-8520
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
ID
Other
Enumeration date
09/05/2024
Last updated
09/19/2024
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