NPI age
19 years
Enumerated 2006-08-31
Across 235 active psychologist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010017563 | BLUE SHIELD |
| 01 (ID) | N5228 | BLUE CROSS |
| 05 (ID) | 805455300 |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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