| A Victors Gathering Counseling Service | |
|
417 E Veatch St Moscow ID 83843-3570 | |
| (208) 874-7989 | |
| Not Available |
| Full Name | A Victors Gathering Counseling Service |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 417 E Veatch St, Moscow, Idaho |
| Authorized Official Name and Position | Kristine Annette Lopez (THERAPIST/OWNER) |
| Authorized Official Contact | 2085964129 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Victors Gathering Counseling Service 417 E Veatch St Moscow ID 83843-3570 Ph: (208) 874-7989 | A Victors Gathering Counseling Service 417 E Veatch St Moscow ID 83843-3570 Ph: (208) 874-7989 |
| NPI Number | 1417597683 |
|---|---|
| Provider Enumeration Date | 01/15/2020 |
| Last Update Date | 12/13/2023 |
| Certification Date | 12/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417597683 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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