State of Idaho
State of Idaho provides Psychologist services in Blackfoot, Idaho. Licensed in Idaho. Registered with an NPI since 2011.
- Licensed in
- ID
- In the registry since
- 2011
Practice location Address checks out
700 E Alice StBlackfoot, ID 83221-4925 Not confirmed with CMS for 15 years — call before visiting
Phone: (208) 785-8506
Fax: (208) 785-8518
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Psychologist (primary) | Taxonomy 103T00000X · Licence 17 (ID) |
|---|
Record details
| NPI number | 1053615260 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | Yes |
| Parent organization | State Hospital South |
| Authorized official | Lorna Colvin — Patient Account Specialist · (208) 785-8506 |
| Other names | State Hospital South Group |
| NPI enumerated | January 3, 2011 |
| Last updated in NPPES | January 3, 2011 |
| Mailing address | 700 E Alice St, Po Box 400, Blackfoot, ID 83221-4925 |
Other providers in Blackfoot
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State of Idaho Department of Health and Welfare
700 E Alice, Blackfoot, ID 83221 · (208) 785-8462