Individual
RODNEY KANIKKEBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
317 W 6TH ST, STE 208, MOSCOW, ID 83843-2321
(208) 882-3504
(208) 882-3572
Mailing address
317 W 6TH ST, STE 208, MOSCOW, ID 83843-2321
(208) 882-3504
(208) 882-3572
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-6234
ID
Other
Enumeration date
06/30/2016
Last updated
06/30/2016
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