| NPI | 1578681508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANNE BEDKE Bookkeeper 208-678-3555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |