Whalio Doctors

NPI 1538412382

Jason Southwick, PHD

Practitioner Clinical Neuropsychologist Boise, ID

Practice location

Address
1055 N Curtis Rd, Boise, ID 83706-1309
Phone
(208) 367-2121
Mailing address
PO Box 190930, Boise, ID 83719-0930

Registered specialties (2)

Clinical Neuropsychologist Primary
Behavioral Health & Social Service Providers Taxonomy 103G00000X Licence PSY - 202728 (ID)
Clinical Psychologist
Behavioral Health & Social Service Providers Taxonomy 103TC0700X Licence PSY - 202728 (ID)

Registry record

NPI
1538412382
Entity type
Individual
Sex (as registered)
Male
NPI issued
17 Oct 2012
Record last updated
18 May 2024

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.