Individual
RILEY FAIRGRIEVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
816 W BANNOCK ST STE 201, BOISE, ID 83702-5896
(208) 987-1436
Mailing address
2014 S DIVISION AVE, BOISE, ID 83706-4211
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-9829
ID
Other
Enumeration date
10/16/2023
Last updated
09/03/2024
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