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Individual

SHANE GRIGGS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
1352 E CENTER ST STE A, POCATELLO, ID 83201-4773
(208) 233-2025
(208) 233-2178
Mailing address
28 WILLOWOOD AVE, POCATELLO, ID 83204-4004
(208) 241-8207
(208) 233-2178

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-6279
ID

Other

Enumeration date
08/02/2016
Last updated
08/02/2016
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