NPI age
20 years
Enumerated 2006-02-24
Across 28 active psychiatry & neurology providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 13426216975 | |
| 01 (SD) | 4994379 | BCBS |
| 05 (SD) | 7101880 |
Solo or small practice. No other active providers share this practice address in NPPES.
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