| Williams Psychology Inc. | |
|
3771 N Eagle Rd Boise ID 83713-5005 | |
| (208) 375-6402 | |
| (888) 505-3331 |
| Full Name | Williams Psychology Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 3771 N Eagle Rd, Boise, Idaho |
| Authorized Official Name and Position | Keith Lee Williams (COMPANY OWNER) |
| Authorized Official Contact | 2083756402 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Williams Psychology Inc. 3771 N Eagle Rd Boise ID 83713-5005 Ph: (208) 375-6402 | Williams Psychology Inc. 3771 N Eagle Rd Boise ID 83713-5005 Ph: (208) 375-6402 |
| NPI Number | 1982943478 |
|---|---|
| Provider Enumeration Date | 02/04/2013 |
| Last Update Date | 02/04/2013 |
| Medicare PECOS PAC ID | 3476791799 |
|---|---|
| Medicare Enrollment ID | O20130528000759 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982943478 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY 202563 (Idaho) | Primary |
| Provider Name | Keith L Williams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174716005 PECOS PAC ID: 6305093188 Enrollment ID: I20120829000903 |
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