| NPI | 1447888656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLL BERNDT Owner 208-268-8858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2020-04-01 |