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1215600291
DAVE MINER
POCATELLO, ID
NPI
1215600291
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: ID LPC-3394)
Enumeration Date
2021-07-27
Last Update Date
2024-01-29
Business Address
DAVE MINER LPC
1250 E OAK ST
POCATELLO, ID 83201-3940
Phone number: 208-425-2489
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Mailing Address
DAVE MINER LPC
500 S 11TH AVE STE 400
POCATELLO, ID 83201-4880
Phone number: 208-232-7862
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