Individual
OLIVER DEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
76 N MAIN ST, DRIGGS, ID 83422-5125
(208) 787-6900
Mailing address
PO BOX 844, DRIGGS, ID 83422-0844
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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