GARY D EDSON

BOISE, ID
NPI1275688012
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: ID  53)
Enumeration Date2007-01-24
Last Update Date2007-07-08
Business Address
-- GARY D EDSON CADC
1055 N CURTIS RD
BOISE, ID 83706-1309
Phone number: 208-367-3069
Mailing Address
-- GARY D EDSON CADC
PO BOX 190930
BOISE, ID 83719-0930
Phone number: 208-367-3069
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