| NPI | 1881401099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA STURGEON FREITAS Owner 208-475-4690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 103TC1900X Psychologist, Counseling | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TF0000X Psychologist, Family | |
| Enumeration Date | 2024-12-12 |
| Last Update Date | 2024-12-12 |