| NPI | 1508339268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH WITT SHOOP Clinician/Provider/Owner 208-576-4371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-01-05 |
| Last Update Date | 2019-02-21 |