| NPI | 1518102797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREVOR ALLEN HALL President 208-672-8699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: ID PSY202444) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2008-12-02 |