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1104279413
COLIN WATERS
AMMON, ID
NPI
1104279413
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: ID LPC-6309)
Enumeration Date
2016-07-21
Last Update Date
2016-07-21
Business Address
-- COLIN WATERS
2705 E 17TH ST
AMMON, ID 83406-6601
Phone number: 208-346-7500
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Mailing Address
-- COLIN WATERS
2705 E 17TH ST
AMMON, ID 83406-6601
Phone number: 208-346-7500
Copy
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