Full Disclosure Therapy
Marriage & Family Therapist in Eagle, ID. Organization (NPI-2).
NPI number1942021589
StatusActive
Last updated in NPPESOct 17, 2024
Details
- NPI
- 1942021589
- Entity type
- Organization (NPI-2)
- Legal business name
- Full Disclosure Therapy
- Organization subpart
- No
- Enumeration date
- Oct 17, 2024
- Certification date
- Sep 16, 2024
- Last updated
- Oct 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | – | – | Yes |
Practice location
172 S Academy Ave Ste 150Eagle, ID 83616-6564
Phone 208-668-2701
Mailing address
238 S Neskowin WayEagle, ID 83616-4964
Phone 310-570-6897
Other practice locations
2001 S Barrington Ave Ste 250
W Los Angeles, CA 90025-5363
W Los Angeles, CA 90025-5363
Phone 310-570-6897
Authorized official
Julie M Rodin
Owner
3105706897
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