| NPI | 1942351150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA MACE-TUCKER Partner 208-661-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCSW1078) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LCSW25136) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2020-08-22 |