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1508647983
NEW MOON MENTAL HEALTH LLC
IDAHO FALLS, ID
NPI
1508647983
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Entity Type
Organization
Authorized Contact
DENISE BARNES
Owner
208-716-6445
Organization Subpart ?
No
Primary Taxonomy
363LP0808X Nurse Practitioner, Psych/Mental Health
Enumeration Date
2023-10-11
Last Update Date
2023-10-11
Business Address
NEW MOON MENTAL HEALTH LLC
1970 E 17TH ST STE 111B
IDAHO FALLS, ID 83404-8046
Phone number: 208-541-5257
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Mailing Address
NEW MOON MENTAL HEALTH LLC
1970 E 17TH ST STE 111B
IDAHO FALLS, ID 83404-8046
Phone number: 208-541-5257
Copy
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