| Mallory Murphy | |
|
172 S Academy Ave Ste 150 Eagle ID 83616-6564 | |
| (208) 891-6439 | |
| Not Available |
| Full Name | Mallory Murphy |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 172 S Academy Ave Ste 150, Eagle, Idaho |
| Authorized Official Name and Position | Mallory Murphy (OWNER) |
| Authorized Official Contact | 2088916439 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mallory Murphy 172 S Academy Ave Ste 150 Eagle ID 83616-6564 Ph: () - | Mallory Murphy 172 S Academy Ave Ste 150 Eagle ID 83616-6564 Ph: (208) 891-6439 |
| NPI Number | 1497478002 |
|---|---|
| Provider Enumeration Date | 09/20/2022 |
| Last Update Date | 09/20/2022 |
| Certification Date | 09/20/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497478002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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