| NPI | 1043512338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILDRED ANN TIKKER Licensed Clinical Social Worker 208-695-1435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCSW-846) |
| Enumeration Date | 2010-11-19 |
| Last Update Date | 2010-12-17 |