| NPI | 1427511203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE KILDOW Clinic Director/Owner 208-442-7791 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2019-04-09 |