Starlight Psychological Services Pllc | |
101 S Park Ave Idaho Falls ID 83402-3627 | |
(208) 715-7551 | |
Not Available |
Full Name | Starlight Psychological Services Pllc |
---|---|
Speciality | Clinic/center - Adult Mental Health |
Location | 101 S Park Ave, Idaho Falls, Idaho |
Authorized Official Name and Position | Ashley Wasilewski (OWNER) |
Authorized Official Contact | 3475155039 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Starlight Psychological Services Pllc 3000 Old Castle Ln Idaho Falls ID 83404-7346 Ph: (347) 515-5039 | Starlight Psychological Services Pllc 101 S Park Ave Idaho Falls ID 83402-3627 Ph: (208) 715-7551 |
NPI Number | 1467136523 |
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Provider Enumeration Date | 06/09/2023 |
Last Update Date | 06/09/2023 |
Certification Date | 06/09/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467136523 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
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