| NPI | 1255548756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P CONDRON Clinical Professional Counselor 208-478-9551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: ID LCPC-3868) |
| Enumeration Date | 2007-05-16 |
| Last Update Date | 2008-04-04 |