Individual
DR. COLLEEN GRAY KLABO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
2076 S EAGLE RD, MERIDIAN, ID 83642-6707
(208) 955-7340
Mailing address
1410 W CAMEL BACK LN, #127, BOISE, ID 83702-6567
(206) 817-4163
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
Primary
PSY-202666
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679741490
—
ID
Enumeration date
02/14/2008
Last updated
04/26/2013
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