| NPI | 1497377469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAVARA D REARDON Owner 208-651-0604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 104100000X Social Worker | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2023-09-20 |