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1205216587
CODY MADDOX
BOISE, ID
NPI
1205216587
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: ID PSY-202857)
Enumeration Date
2015-06-02
Last Update Date
2015-06-02
Business Address
-- CODY MADDOX
500 W FORT ST
BOISE, ID 83702-4501
Phone number: 208-422-1000
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Mailing Address
-- CODY MADDOX
500 W FORT ST
BOISE, ID 83702-4501
Phone number:
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