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Contact Information

IDAHO MEMORY & AGING CENTER PLLC
413 N ALLUMBAUGH ST
STE# 101
BOISE, ID83704-9212
 Phone: 617-922-4957
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for IDAHO MEMORY AGING CENTER PLLC · (Female)

NPI Number 1730528548
Status Active
Credentials
Entity Individual
Enumeration date 06/14/2013
Last updated 07/19/2013 - About 13 years ago
Sole proprietor 1 Not specified
Identifiers
  • ID License # M-12079
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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