| NPI | 1104135375 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISON DUNBAR Reimbursement Manager 208-323-1125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry (Licence: ID M8955) |
| Enumeration Date | 2010-10-05 |
| Last Update Date | 2010-12-27 |