| NPI | 1982943478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH LEE WILLIAMS Company Owner 208-375-6402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: ID PSY 202563) |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2013-02-04 |