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Individual

KEITH DEUGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CADC

Contact information

Practice address
7941 W RIFLEMAN ST, BOISE, ID 83704-9001
(208) 895-7950
Mailing address
7941 W RIFLEMAN ST, BOISE, ID 83704-9001

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
11663
ID

Other

Enumeration date
07/17/2019
Last updated
07/17/2019
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