Individual
MR. DREY VAN CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
8050 W RIFLEMAN ST STE 100, BOISE, ID 83704-9006
(208) 321-0634
Mailing address
8050 W RIFLEMAN ST STE 100, BOISE, ID 83704-9006
(208) 321-0634
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCSW-32396
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265565477
—
ID
Enumeration date
09/21/2012
Last updated
09/21/2012
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