| Psychological Service Associates | |
|
2235 E 25th St Suite 290 Idaho Falls ID 83404-7519 | |
| (208) 525-2090 | |
| (208) 525-2662 |
| Full Name | Psychological Service Associates |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 2235 E 25th St, Idaho Falls, Idaho |
| Authorized Official Name and Position | Howard K Harper (OWNER) |
| Authorized Official Contact | 2085520490 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Psychological Service Associates Po Box 3480 Idaho Falls ID 83403-3480 Ph: (208) 525-2090 | Psychological Service Associates 2235 E 25th St Suite 290 Idaho Falls ID 83404-7519 Ph: (208) 525-2090 |
| NPI Number | 1871672840 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 06/29/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871672840 | NPI | - | NPPES |
| 806472900 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY-386 (Idaho) | Primary |
| 106H00000X | Marriage & Family Therapist | LMFT-2661 (Idaho) | Secondary |
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