| NPI | 1821388505 |
|---|---|
| Doing Business As | LIFESPAN FAMILY PRACTICE MENTAL HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | WENDY L MCKNIGHT Owner 208-736-7090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2011-04-14 |