Klabo, Colleen Gray

Klabo, Colleen Gray is an individual health care provider with primary practice located at 2076 S Eagle Rd , Meridian ID 83642-6707. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is her primary health care specialty. Klabo, Colleen Gray can be contacted via phone (208) 955-7340.

Contact Information

Primary practice address
2076 S Eagle Rd Meridian ID 83642-6707
Phone: (208) 955-7340
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY-202666 Idaho

Profile Details

NPI number 1679741490
LBN Legal business name Klabo, Colleen Gray
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2008
Last updated Apr 26th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1679741490 NPPES
Idaho MEDICAID 1679741490

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