| Full Disclosure Therapy | |
|
172 S Academy Ave Ste 150 Eagle ID 83616-6564 | |
| (208) 668-2701 | |
| Not Available |
| Full Name | Full Disclosure Therapy |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 172 S Academy Ave Ste 150, Eagle, Idaho |
| Authorized Official Name and Position | Julie M Rodin (OWNER) |
| Authorized Official Contact | 3105706897 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Full Disclosure Therapy 238 S Neskowin Way Eagle ID 83616-4964 Ph: (310) 570-6897 | Full Disclosure Therapy 172 S Academy Ave Ste 150 Eagle ID 83616-6564 Ph: (208) 668-2701 |
| NPI Number | 1942021589 |
|---|---|
| Provider Enumeration Date | 10/17/2024 |
| Last Update Date | 10/17/2024 |
| Certification Date | 09/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942021589 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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