Individual
WALTER ALBERT BOGUCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC
Contact information
Practice address
508 E FLORIDA AVE, NAMPA, ID 83686-5823
(208) 463-0118
(208) 463-1507
Mailing address
508 E FLORIDA AVE, NAMPA, ID 83686-5823
(208) 463-0118
(208) 463-1507
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
10067
ID
Other
Enumeration date
08/14/2013
Last updated
08/14/2013
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