NPI age
18 years
Enumerated 2008-02-12
Across 1998 active counselor providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 | 000010165071 | REGENCE BLUE SHIELD OF ID |
| 05 (ID) | 807499000 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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