Regents of the University of Idaho Child & Youth Study Center

NPI #1609902980 in Moscow, Idaho

Provider Information

NPI Number: 1609902980
Entity Type: Organization
Organization Name: Regents of the University of Idaho Child & Youth Study Center
Primary Specialty: Psychologist - Clinical Child & Adolescent
Enumeration Date: Feb 23, 2007
Last Updated: Apr 1, 2014

Practice Location

Address: 121 WEST SWEET AVENUE
City: Moscow
State: Idaho
ZIP Code: 83843
Phone: (208) 885-6191

Authorized Official

Name: DR. GWEN ELAINE MITCHELL, LPC, NCSP
Title: DIRECTOR
Phone: (208) 885-6191

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical Child & Adolescent — Clinical Child & Adolescent	103TC2200X	Primary

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