| NPI | 1821263088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT W SCANLON Executive Director 208-331-1155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: ID D33630) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: ID PSY331) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2008-11-21 |