MR. Clark William Guest, LAADC #LNR2090411

NPI #1215147400 in Hayden, Idaho

Provider Information

NPI Number: 1215147400
Entity Type: Individual
Name: MR. Clark William Guest, LAADC #LNR2090411
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Counselor - Professional
Credential: LAADC #LNR2090411
Enumeration Date: May 23, 2007
Last Updated: May 16, 2022

Practice Location

Address: 9494 N GOVERNMENT WAY # 202
City: Hayden
State: Idaho
ZIP Code: 83835-9848
Phone: (208) 449-2509

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Marriage & Family Therapist	106H00000X
Counselor - Professional — Professional	101YP2500X	Primary

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