| The Neurodevelopment Resource Center | |
|
950 W Bannock St Ste 1100 Boise ID 83702-6140 | |
| (208) 947-5368 | |
| (888) 328-9210 |
| Full Name | The Neurodevelopment Resource Center |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 950 W Bannock St Ste 1100, Boise, Idaho |
| Authorized Official Name and Position | Cindy Nilsson (CLINIC DIRECTOR) |
| Authorized Official Contact | 2089475368 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Neurodevelopment Resource Center 950 W Bannock St Ste 1100 Boise ID 83702-6140 Ph: (208) 947-5368 | The Neurodevelopment Resource Center 950 W Bannock St Ste 1100 Boise ID 83702-6140 Ph: (208) 947-5368 |
| NPI Number | 1275891194 |
|---|---|
| Provider Enumeration Date | 04/28/2012 |
| Last Update Date | 04/28/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275891194 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | PSY-230 (Idaho) | Primary |
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