| NPI | 1316245004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISON DUNBAR Billing Supervisor 208-323-1125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: ID M4922) |
| Enumeration Date | 2011-03-04 |
| Last Update Date | 2011-03-04 |