SHANE M CLUBB

MERIDIAN, ID
NPI1871554584
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor Mental Health
(Licence: ID  LCPC-3989)
Enumeration Date2006-03-31
Last Update Date2012-12-10
Business Address
MR. SHANE M CLUBB M.A., L.C.P.C.
39 E STATE AVE
MERIDIAN, ID 83642-2342
Phone number: 208-994-3599
Mailing Address
MR. SHANE M CLUBB M.A., L.C.P.C.
39 E STATE AVE
MERIDIAN, ID 83642-2342
Phone number: 208-994-3599
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