Blackfoot Medical Clinic Mental Health

NPI #1265635205 in Blackfoot, Idaho

Provider Information

NPI Number: 1265635205
Entity Type: Organization
Organization Name: Blackfoot Medical Clinic Mental Health
Primary Specialty: Counselor - Professional
Enumeration Date: Jun 7, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1441 PARKWAY DR
City: Blackfoot
State: Idaho
ZIP Code: 83221-1667
Phone: (208) 785-2600

Authorized Official

Name: BETTY MILLER
Title: BUSINESS OFFICE MANAGER
Phone: (208) 785-2600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Professional — Professional	101YP2500X	Primary

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