NPI age
19 years
Enumerated 2006-06-19
Across 1313 active counselor providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010034754 | BLUE SHIELD |
| 05 (ID) | 806162000 | |
| 01 (ID) | Q2701 | BLUE CROSS |
Part of a multi-provider practice. 13 other active providers share this practice address in NPPES.
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