| NPI | 1972626182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN STEVENS Owner 208-255-2004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-26084) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-335) |
| 106H00000X Marriage & Family Therapist (Licence: ID LMFT-2843) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |