NPI age
20 years
Enumerated 2006-03-15
Across 235 active psychologist providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010016346 | BLUE SHIELD |
| 05 (ID) | 002182400 | |
| 01 (ID) | N2860 | BLUE CROSS |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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