Organization · Type 2 NPI
Modern Psychotherapy Services
Professional Counselor · Eagle, ID
NPI number
1649674888
Active
Practice location
4875 W Athens Ct
Eagle, ID 83616-5138
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Professional Counselor Primary | 101YP2500X | LPC-5605 (ID) |
Professional Counselor: Definition to come...
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About NPI 1649674888
Modern Psychotherapy Services's National Provider Identifier is 1649674888, issued on Oct 17, 2014. The primary taxonomy on file is Professional Counselor (101YP2500X), and the practice location is in Eagle, ID. The record was last updated on Oct 17, 2014.