Individual
DR. DAVID THOMAS HARGRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
523 E 4TH S, REXBURG, ID 83440-2512
(208) 359-0836
Mailing address
523 E 4TH S, REXBURG, ID 83440-2512
(208) 359-0836
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY222
ID
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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