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Individual

MR. RANDALL DEAN MEENACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A.

Contact information

Practice address
1517 W JEFFERSON ST, BOISE, ID 83702-5218
(208) 385-0888
(208) 385-0024
Mailing address
7329 SWIFT LN, BOISE, ID 83704-5963
(208) 794-3053

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-3608
ID

Other

Enumeration date
01/09/2008
Last updated
01/09/2008
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