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Individual

MR. ANTHONY GRANT HALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.COUN., L.P.C.

Contact information

Practice address
5185 W OVERLAND RD, BOISE, ID 83705-2635
(208) 866-7376
Mailing address
12629 W ROSEGLEN CT, BOISE, ID 83713-1437
(208) 866-7376

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-5402
ID
101YP2500X
Professional Counselor
LPC-5402
ID

Other

Enumeration date
09/13/2016
Last updated
09/13/2016
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