| NPI | 1457993230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMI MORGAN Member 208-890-7165 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2019-10-12 |
| Last Update Date | 2019-10-12 |