Individual
TRAVIS KURT BYBEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
767 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5286
(208) 542-0352
(208) 542-0359
Mailing address
767 S WOODRUFF AVE, IDAHO FALLS, ID 83401-5286
(208) 542-0352
(208) 542-0359
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW-26094
ID
Other
Enumeration date
05/31/2007
Last updated
07/09/2007
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