NPI 1104004928

Idaho Dept of Health & Welfare Amhcalpgreg3

Organisation Prescribing (Medical) Psychologist Caldwell, ID

Practice location

Address: 3402 Franklin Rd, Caldwell, ID 83605-6932
Phone: (208) 459-0092
Fax: (208) 454-7714

Authorised official

Name: Todd L Hurt
Title: Field Operations Manager
Phone: (208) 455-7057

Registered specialties

Prescribing (Medical) Psychologist Primary

Behavioral Health & Social Service Providers Taxonomy 103TP0016X

Other Psychologist providers in Idaho →

Registry record

NPI: 1104004928
Entity type: Organization
NPI issued: 4 Feb 2008
Record last updated: 28 Jan 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.