Individual
JOSHUA BYNUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.
Contact information
Practice address
651 N EAGLE RD, EAGLE, ID 83616-5007
(208) 477-8351
Mailing address
544 N EAGLE RD, EAGLE, ID 83616-5004
(208) 477-8351
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-6173
ID
Other
Enumeration date
05/09/2016
Last updated
04/05/2018
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