Greater Mind Integration, PLLC
Counselor, Mental Health in Boise, ID. Organization (NPI-2).
NPI number1295559797
StatusActive
Last updated in NPPESNov 12, 2024
Details
- NPI
- 1295559797
- Entity type
- Organization (NPI-2)
- Legal business name
- Greater Mind Integration, PLLC
- Organization subpart
- No
- Enumeration date
- Nov 12, 2024
- Certification date
- Nov 12, 2024
- Last updated
- Nov 12, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
Practice location
3350 W Americana Ter Ste 330cBoise, ID 83706-2547
Phone 208-273-3514 · Fax 208-593-4357
Mailing address
2800 N Bogus Basin Rd Apt D103Boise, ID 83702-0976
Phone 208-866-3971
Authorized official
Tracy Lynn Roe
Owner/Provider
2088663971
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