Modern Psychotherapy Services

NPI #1649674888 in Eagle, Idaho

Provider Information

NPI Number
1649674888
Entity Type
Organization
Organization Name
Modern Psychotherapy Services
Primary Specialty
Counselor - Professional
Enumeration Date
Oct 17, 2014
Last Updated
Oct 17, 2014

Practice Location

Address
4875 W ATHENS CT
City
Eagle
State
Idaho
ZIP Code
83616-5138
Phone
(208) 731-7646

Authorized Official

Name
DIANA LINCOLN-HAYE, LPC
Title
PRESIDENT
Phone
(208) 731-7646

Specialties & Taxonomy Codes

Specialty
Counselor - ProfessionalProfessional

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