| NPI | 1871245001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN R PORTER Owner 208-346-2363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 106H00000X Marriage & Family Therapist | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2022-01-19 |
| Last Update Date | 2022-01-19 |