| NPI | 1508100876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER REHIL Chief Psychologist 208-550-3165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: ID PSY-202671) |
| Enumeration Date | 2012-11-26 |
| Last Update Date | 2020-07-27 |