Individual
KEVIN ROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
7227 W POTOMAC DR, BOISE, ID 83704-9150
(208) 440-7388
Mailing address
7227 W POTOMAC DR, BOISE, ID 83704-9150
(208) 440-7388
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC-5036
ID
Other
Enumeration date
12/13/2013
Last updated
02/09/2017
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