Individual
DYLAN ROGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
4615 W EMERALD ST, BOISE, ID 83706-2002
(208) 344-2228
(208) 930-1695
Mailing address
2118 S KERR ST, BOISE, ID 83705-3414
(651) 334-9896
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8245
ID
Other
Enumeration date
07/03/2021
Last updated
02/03/2022
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