| NPI | 1437452828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA J WATERHOUSE Sole Owner 208-263-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ID PSY-202071) |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2010-12-07 |