CODY MADDOX

BOISE, ID
NPI1205216587
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy103TC0700X Psychologist, Clinical
(Licence: ID  PSY-202857)
Enumeration Date2015-06-02
Last Update Date2015-06-02
Business Address
-- CODY MADDOX
500 W FORT ST
BOISE, ID 83702-4501
Phone number: 208-422-1000
Mailing Address
-- CODY MADDOX
500 W FORT ST
BOISE, ID 83702-4501
Phone number:
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