NPI | 1053444604 |
---|---|
Entity Type | Organization |
Authorized Contact | JAMES R PHILLIPS Licensed Psychologist 208-746-7266 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: ID LCPC-144) |
Additional Taxonomies | 103T00000X Psychologist (Licence: ID PSY-305) |
Enumeration Date | 2007-03-13 |
Last Update Date | 2025-09-11 |