| NPI | 1841140928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE MICHELLE GOWANS Practice Administrator 208-375-3230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2026-01-29 |
| Last Update Date | 2026-01-29 |