| Sandpoint Neurotherapy | |
|
2023 Sandpoint West Dr Sandpoint ID 83864-7304 | |
| (208) 265-5412 | |
| Not Available |
| Full Name | Sandpoint Neurotherapy |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 2023 Sandpoint West Dr, Sandpoint, Idaho |
| Authorized Official Name and Position | Eric Robert Ridgway (PRESIDENT/OWNER) |
| Authorized Official Contact | 2082655412 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandpoint Neurotherapy 2023 Sandpoint West Dr Sandpoint ID 83864-7304 Ph: (208) 265-5412 | Sandpoint Neurotherapy 2023 Sandpoint West Dr Sandpoint ID 83864-7304 Ph: (208) 265-5412 |
| NPI Number | 1407203623 |
|---|---|
| Provider Enumeration Date | 05/17/2016 |
| Last Update Date | 10/02/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407203623 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LCPC 135 (Idaho) | Primary |
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