| NPI | 1174268155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH LYNN Clinical Director 208-261-2411 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2022-11-01 |