Individual
MR. GRANT RICHARD KANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
10740 W FAIRVIEW AVE STE 100, BOISE, ID 83713-8050
(208) 376-0191
Mailing address
8905 WEST CORNWALL DRIVE, BOISE, ID 83704-4310
(208) 322-7599
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW63
ID
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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