| NPI | 1639270937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANNE BEDKE Bookkeeper 208-678-3555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-08-22 |