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Individual

COLLIN ROSS KEATING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LSWAIC, MHP, CPC

Contact information

Practice address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-4000
Mailing address
2003 KOOTENAI HEALTH WAY, COEUR D ALENE, ID 83814-6051
(208) 625-4000

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CG60551404
WA

Other

Enumeration date
11/06/2018
Last updated
03/12/2021
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