| NPI | 1427599885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN M MICHAUD Clincial Psycologiist, Sole Mbr 208-971-5806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ID PSY202738) |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2017-03-24 |