Individual
ERIC EVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
500 W FORT ST, B114, BOISE, ID 83702-4501
(208) 422-1108
Mailing address
500 W FORT ST, B114, BOISE, ID 83702-4501
(208) 422-1108
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC - 5380
ID
103TC0700X
Clinical Psychologist
Primary
PSY-202920
ID
Other
Enumeration date
07/30/2013
Last updated
05/02/2016
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