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Individual

KEVIN HOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
301 DEINHARD LN, MCCALL, ID 83638-4703
(208) 630-2450
(208) 634-4055
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC-9531
ID
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
01/19/2023
Last updated
11/07/2024
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