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1205182912
MIGUEL ANGEL MOUW
BOISE, ID
NPI
1205182912
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID 1360009)
Enumeration Date
2012-07-31
Last Update Date
2012-07-31
Business Address
-- MIGUEL ANGEL MOUW ICADC
205 OAKHURST WAY
BOISE, ID 83709-0534
Phone number: 208-353-5846
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Mailing Address
-- MIGUEL ANGEL MOUW ICADC
205 OAKHURST WAY
BOISE, ID 83709-0534
Phone number: 208-353-5846
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