| Trauma And Grief Counseling, Llc | |
|
5164 Canterbury St Chubbuck ID 83202-5065 | |
| (208) 251-6030 | |
| Not Available |
| Full Name | Trauma And Grief Counseling, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5164 Canterbury St, Chubbuck, Idaho |
| Authorized Official Name and Position | Brooks Bastian Hanks (OWNER) |
| Authorized Official Contact | 2082516030 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Trauma And Grief Counseling, Llc 5164 Canterbury St Chubbuck ID 83202 Ph: (208) 251-6030 | Trauma And Grief Counseling, Llc 5164 Canterbury St Chubbuck ID 83202-5065 Ph: (208) 251-6030 |
| NPI Number | 1942054838 |
|---|---|
| Provider Enumeration Date | 04/16/2024 |
| Last Update Date | 04/16/2024 |
| Certification Date | 04/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942054838 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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