NPI age
15 years
Enumerated 2010-12-07
Across 235 active psychologist providers in Idaho.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 8066666574200 | |
| 01 (ID) | N5327 | BLUE CROSS |
| 01 (ID) | 86519 | REGENCE |
Multi-provider organization. 1 individual provider on file at this primary address.
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