NPI 1174682959

Idaho State University, Psychology Clinic

Organisation Community/Behavioral Health Agency Pocatello, ID

Practice location

Address: Isu Psychology Clinic Idaho State University 921 S. 8th Avenue, Stop 8021, Pocatello, ID 83209-0001
Phone: (208) 282-2129
Fax: (208) 282-5411

Authorised official

Name: Anthony J. Cellucci
Title: Director of Psych Clinic
Phone: (208) 282-2129

Registered specialties

Community/Behavioral Health Agency Primary

Agencies Taxonomy 251S00000X Licence 344 (ID)

Other Community/Behavioral Health providers in Idaho →

Registry record

NPI: 1174682959
Entity type: Organization
NPI issued: 7 Dec 2006
Record last updated: 17 Jun 2008

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.