Individual
MATTHEW KAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4650 HAWTHORNE RD STE 3B, CHUBBUCK, ID 83202-2376
(208) 252-5621
(208) 648-4167
Mailing address
4650 HAWTHORNE RD STE 3B, CHUBBUCK, ID 83202-2376
(208) 252-5621
(208) 648-4167
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
LPC5260
ID
Other
Enumeration date
06/14/2011
Last updated
04/12/2024
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