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Individual

TED ROBY BOST III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
5001 CHERRY GULCH LN, EMMETT, ID 83617-5123
(208) 365-3437
Mailing address
5001 CHERRY GULCH LN, EMMETT, ID 83617-5123
(208) 365-3437

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-6834
ID

Other

Enumeration date
03/27/2024
Last updated
03/27/2024
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