ROBERT ANDREW DE WALL

POCATELLO, ID
NPI1114228384
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YP2500X Counselor, Professional
(Licence: ID  LCPC-4672)
Enumeration Date2010-11-04
Last Update Date2021-10-22
Business Address
ROBERT ANDREW DE WALL LCPC
444 HOSPITAL WAY STE 477
POCATELLO, ID 83201-2744
Phone number: 208-233-7832
Mailing Address
ROBERT ANDREW DE WALL LCPC
65 FORDHAM ST
POCATELLO, ID 83201-3418
Phone number: 208-317-0027
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