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Individual

MRS. KIRSTEN LEE GRIGGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
310 N 2ND E STE 114, REXBURG, ID 83440-1606
(208) 359-0581
(208) 359-1125
Mailing address
PO BOX 420, SUGAR CITY, ID 83448-0420
(208) 390-4122
(208) 359-1125

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-371
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010156968
BLUE SHIELD OF IDAHO
ID
01
Q7359
BLUE CROSS
ID
Enumeration date
08/31/2006
Last updated
07/09/2007
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