Individual
KAVIN BRANHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
72 S 1ST E STE 103, REXBURG, ID 83440-1965
(208) 356-4900
(208) 624-4030
Mailing address
PO BOX 18, SAINT ANTHONY, ID 83445-0018
(208) 356-4900
(208) 624-4030
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-7894
ID
Other
Enumeration date
06/24/2016
Last updated
09/26/2024
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