| NPI | 1578499414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH JANE SHARP Credentialing And Billing Associate 208-996-3542 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2026-06-19 |
| Last Update Date | 2026-06-22 |