STATE OF IDAHO
Psychologist
Active
Organization
NPI: 1053615260
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Psychologist | 103T00000X | Yes | 17 (ID) |
Frequently Asked Questions
NPI 1053615260 is the National Provider Identifier for STATE OF IDAHO, a Psychologist provider located in Blackfoot, ID. This NPI was enumerated on January 3, 2011.
Quick Facts
- NPI
- 1053615260
- Type
- Organization
- Enumerated
- Jan 3, 2011
- Last Updated
- Jan 3, 2011
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