Individual provider · Type 1 NPI

Bo Robert Smith

Mental Health Counselor · Blackfoot, ID

NPI number 1104623784 Active

Practice location

1309 Camas St
Blackfoot, ID 83221-3060

Call (208) 782-0675 Map

Mailing address

297 Pendlebury Ln Apt 1
Blackfoot, ID 83221-2815

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X3071150 (ID)

Mental Health Counselor: Definition to come...

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About NPI 1104623784

Bo Robert Smith's National Provider Identifier is 1104623784, issued on Feb 28, 2025. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Blackfoot, ID. The record was last updated on Feb 28, 2025.