NPI age
18 years
Enumerated 2008-01-11
Across 1998 active counselor providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (CO) | 532691 | |
| 01 (CO) | 12018498 | CAQH |
Solo or small practice. No other active providers share this practice address in NPPES.
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