NPI age
20 years
Enumerated 2006-04-27
Across 245 active psychiatry & neurology providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | P01019576 | MCRR |
| 05 (ID) | 1689631350 |
Part of a multi-provider practice. 11 other active providers share this practice address in NPPES.
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