NPI age
18 years
Enumerated 2007-10-24
Across 235 active psychologist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 10139177 | REGENCE |
| 05 (ID) | 806574200 | |
| 01 (ID) | N5327 | BLUE CROSS |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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