Eagle Crest Life Services
NPI #1659572493 in Coeur D Alene, Idaho
Provider Information
- NPI Number
- 1659572493
- Entity Type
- Organization
- Organization Name
- Eagle Crest Life Services
- Primary Specialty
- Psychologist - Prescribing (Medical)
- Enumeration Date
- May 30, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 416 E COEUR DALENE AVE
- City
- Coeur D Alene
- State
- Idaho
- ZIP Code
- 83814-2825
- Phone
- (208) 666-9162
Authorized Official
- Name
- ROBERT WHEELER
- Title
- PRESIDENT
- Phone
- (208) 666-9162
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - Prescribing (Medical) — Prescribing (Medical) |
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Individual Providers
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|---|---|
| MS. Joanna Elise Wiese |  AI Deep Dive |
| DR. Patrick Jon Bartos, PSY.D., MSCP | AI Deep Dive |
| DR. Brandon J. Henscheid, PSY.D. | AI Deep Dive |
| Joseph Wassif | AI Deep Dive |
Organizations
| Provider Name | |
|---|---|
| Idaho Dept of Health & Welfare Amhcalpgreg3 | AI Deep Dive |
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