person
Richard Harold Degraw
Mental Health Counselor in Rexburg, Idaho
NPI 1275014045

Richard Harold Degraw is a Mental Health Counselor based in Rexburg, ID and is specialized in Mental Health. Richard Harold Degraw practices in Rexburg, ID. The NPI Number for Richard Harold Degraw is 1275014045 and holds a License No. LPC-6097 (Idaho).

The current practice location address for Richard Harold Degraw is 60 W Main St, Rexburg, ID and can be reached out via phone at 208-359-3300 and via fax at 208-359-3345.

Location: 60 W Main St, Rexburg, ID, 83440-1825
person
Provider Profile Details
NPI Number
1275014045
Provider Name
Richard Harold Degraw
Credential
Provider Entity Type
Individual
Gender
Male
Address
60 W Main St, Rexburg, ID, 83440-1825
Phone Number
208-359-3300
Fax Number
208-359-3345
Provider Enumeration Date
08/28/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
60 W Main St
City
State
Zip
83440-1825
Phone Number
208-359-3300
Fax Number
208-359-3345
person
Provider Business Mailing Address Details
Address
60 W Main St
City
State
Zip
83440-1825
Phone Number
208-359-3300
Fax Number
208-359-3345
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
LPC-6097 (Idaho)
Definition
Definition to come...
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