All Medicaid billing entities listing RAVSTEN, DERIC (OWNER) as their authorized official in the NPPES registry.
| State | Entities | Total Paid |
|---|---|---|
| Idaho | 1 | $411K |
| # | Provider | Location | Specialty | Total Paid |
|---|---|---|---|---|
| 1 | LIFE CHANGE ASSOCIATES, PC | POCATELLO, ID | Mental Health Counselor | $411K |