| NPI | 1750257184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH S BLACK Owner/CEO 208-207-8331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2025-10-13 |
| Last Update Date | 2025-10-13 |