Individual
MR. DARREL W KIPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS ACADC
Contact information
Practice address
111 BEVER GRADE ROAD, NIMIIPOO HEALTH, LAPWAI, ID 83540
(208) 843-2391
(208) 843-7394
Mailing address
812 7TH AVENUE, LEWISTON, ID 83501
(208) 746-3889
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
83ACADC
ID
Other
Enumeration date
01/09/2007
Last updated
07/08/2007
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