| NPI | 1912496035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRESE A DONNELLY Owner 208-850-1886 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2024-10-16 |