| NPI | 1063574226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET O. ALLEN Clinical Director 208-529-5777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ID NP1094A) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2013-10-15 |