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Individual

MR. GREGORY J DUNKLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S.

Contact information

Practice address
10740 W FAIRVIEW AVE, SUITE 100, BOISE, ID 83713-7926
(208) 376-0190
(208) 658-6299
Mailing address
12485 W ROCKBURY ST, BOISE, ID 83709-0015
(208) 921-4129
(208) 658-0153

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LMFT-3165
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010156963
REGENCE BS IDENT. #
ID
01
Q7421
BCBS SERVICE #
ID
Enumeration date
05/01/2007
Last updated
07/08/2007
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