| NPI | 1609997147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT MARSHAL THOMPSON Behavioral Theripist 208-737-0808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: ID License not needed) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |