| Doctor Name: | KRAIG BOYD |
| NPI Number: | 1043604408 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | LPC-4409 |
| Business Practice Address: | 343 E Bonneville St Pocatello, ID - 832016434 |
| Business Phone Number: | 2082339135 |
| Business Fax Number: | 2082339136 |
| Mailing Address: | Po Box 6249, POCATELLO |
| State: | ID |
| Postal Code: | 832056249 |
| Phone Number: | 2082339135 |
| Fax Number: | 2082339136 |
| NPI Enumeration Date: | 03/24/2015 |
| NPI Last Update Date: | 03/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | LPC-4409 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ID |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |