| NPI | 1235808528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA RANDALL GRADE Owner/ Therapist 208-559-6197 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker | |
| Enumeration Date | 2021-09-09 |
| Last Update Date | 2021-09-09 |