Northwest Neurobehavioral Health Pllc | |
6003 Overland Rd Ste 301 Boise ID 83709-3077 | |
(208) 672-8699 | |
(208) 672-9308 |
Full Name | Northwest Neurobehavioral Health Pllc |
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Speciality | Psychologist - Clinical |
Location | 6003 Overland Rd Ste 301, Boise, Idaho |
Authorized Official Name and Position | Trevor Allen Hall (PRESIDENT) |
Authorized Official Contact | 2086728699 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Northwest Neurobehavioral Health Pllc 6003 Overland Rd Ste 301 Boise ID 83709-3077 Ph: (208) 672-8699 | Northwest Neurobehavioral Health Pllc 6003 Overland Rd Ste 301 Boise ID 83709-3077 Ph: (208) 672-8699 |
NPI Number | 1518102797 |
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Provider Enumeration Date | 12/02/2008 |
Last Update Date | 12/02/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518102797 | NPI | - | NPPES |
1306914643 | Other | ID | IND NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | PSY202444 (Idaho) | Primary |
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