| NPI | 1669247755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIANNA DAWKINS Licensed Professional Counselor 208-994-4234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2023-11-17 |
| Last Update Date | 2023-11-20 |