NPI age
19 years
Enumerated 2007-02-10
Across 1998 active counselor providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | Q1109 | BLUE CROSS |
| 01 (ID) | 000010016363 | REGENCE BLUE SHIELD |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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