Individual
TAYLOR L RED ELK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
2275 W BROADWAY ST STE G, IDAHO FALLS, ID 83402-2902
(208) 524-7400
Mailing address
2275 W BROADWAY ST., SUITE G, IDAHO FALLS, ID 83402
(208) 524-7400
(208) 524-8004
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC-8325
ID
Other
Enumeration date
07/09/2019
Last updated
07/07/2022
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