NPI age
20 years
Enumerated 2005-09-20
Across 1998 active counselor providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010140465 | REGENCE BLUESHIELD ID # |
| 01 (ID) | 200000062851 | BLUE CROSS OF IDAHO |
| 05 (ID) | 7365212 |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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