| NPI | 1184766396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH AL LIPETZKY Manager 208-373-0790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2024-08-14 |