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Individual

RYAN NELSON CRAGG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCPC, LPC

Contact information

Practice address
403 W CHERRY LN, MERIDIAN, ID 83642-1610
(208) 887-1911
(208) 895-8049
Mailing address
403 W CHERRY LN, MERIDIAN, ID 83642-1610
(208) 887-1911
(208) 895-8049

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-7552
ID

Other

Enumeration date
06/15/2009
Last updated
11/28/2021
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