Powder Basin Associates

NPI #1184881153 in Kellogg, Idaho

Provider Information

NPI Number: 1184881153
Entity Type: Organization
Organization Name: Powder Basin Associates
Primary Specialty: Counselor - Mental Health
Enumeration Date: May 19, 2008
Last Updated: May 19, 2008

Practice Location

Address: 204 OREGON ST
City: Kellogg
State: Idaho
ZIP Code: 83837-5008
Phone: (208) 783-0427

Authorized Official

Name: LYNN A MOORE, CPC
Title: OWNER PRESIDENT
Phone: (208) 209-0535

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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