NPI age
19 years
Enumerated 2007-01-22
Across 235 active psychologist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010015907 | REGENCE BLUE SHIELD |
| 01 (ID) | N0617 | BLUE CROSS |
Solo or small practice. No other active providers share this practice address in NPPES.
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