| NPI | 1326162835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER CLAUS EHLERT Owner 208-667-0544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: ID PSY56) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WA PY00000622) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2008-07-10 |