Individual
RYAN VIGILANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
671 E RIVERPARK LN STE 120, BOISE, ID 83706-4000
(601) 207-2103
Mailing address
671 E RIVERPARK LN STE 120, BOISE, ID 83706-4000
(601) 207-2103
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-7743
ID
101YM0800X
Mental Health Counselor
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Other
Enumeration date
06/13/2020
Last updated
02/28/2024
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