Individual
CODY BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1611 N WHITLEY DR, FRUITLAND, ID 83619-2177
(208) 291-1020
Mailing address
1611 N WHITLEY DR, FRUITLAND, ID 83619-2177
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
5671
ID
101YM0800X
Mental Health Counselor
Primary
LH61136624
WA
Other
Enumeration date
12/01/2015
Last updated
02/21/2025
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