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 |