Individual
MR. GARRETT LEE COBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
13500 S. PLEASANT VALLEY RD, KUNA, ID 83634
(208) 336-0740
Mailing address
PO BOX 14, KUNA, ID 83634-0014
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC 3851
ID
Other
Enumeration date
01/11/2009
Last updated
11/20/2009
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