NPI age
19 years
Enumerated 2006-08-30
Across 1313 active counselor providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (UT) | N5277 | BLUE CROSS |
| 01 (ID) | 000010027086 | BLUE SHIELD |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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