Individual
MR. STEVEB JOHN MOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2375 E SUNNYSIDE RD, SUITE C, IDAHO FALLS, ID 83404-8280
(208) 529-5777
(208) 529-5778
Mailing address
2375 E SUNNYSIDE RD, SUITE C, IDAHO FALLS, ID 83404-8280
(208) 529-5777
(208) 529-5778
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-3913
ID
Other
Enumeration date
11/08/2007
Last updated
11/08/2007
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