NPI age
12 years
Enumerated 2014-05-09
Across 1998 active counselor providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 488228600C1 | |
| 01 (ID) | 20002621 | PROVIDER TRANSACTION ACCESS NUMBER |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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