Individual
MR. LOREN RAYMOND CAUDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
127 S WASHINGTON ST STE 5, MOSCOW, ID 83843-2866
(208) 883-9927
(208) 883-9935
Mailing address
127 S WASHINGTON ST STE 5, MOSCOW, ID 83843-2866
(208) 883-9927
(208) 883-9935
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CL60200343
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
507297
WA
101YP2500X
Professional Counselor
Primary
LPC7663
ID
Other
Enumeration date
07/03/2013
Last updated
12/29/2020
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