| NPI | 1457084667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERRIDITH MANNING Member, Owner 208-917-2543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2024-08-21 |