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1144714114
KEITH MICHAEL MOORE
BOISE, ID
NPI
1144714114
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: ID LPC-6900)
Enumeration Date
2018-06-21
Last Update Date
2018-06-21
Business Address
KEITH MICHAEL MOORE LPC
2316 N COLE RD STE A
BOISE, ID 83704-7365
Phone number: 208-323-2273
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Mailing Address
KEITH MICHAEL MOORE LPC
1516 1/2 N 7TH ST
BOISE, ID 83702-3733
Phone number: 208-651-0203
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