| NPI | 1154783538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA MURPHY Medical Staff COO Rdinator 208-232-7862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: ID SE-202913) |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2020-08-17 |