# SNAKE RIVER PSYCHIATRY PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902771678
- **Authorized official:** SEAN HAGGERTY PMHNP-BC (SOLE MEMBER)
- **Authorized official phone:** (208) 906-4073

## Contact information

- **Practice address:** 13972 TRAPPER LN, CALDWELL, ID 83607-5481
- **Practice address phone:** (208) 906-4073
- **Mailing address:** 13972 TRAPPER LN, CALDWELL, ID 83607-5481
- **Mailing address phone:** (208) 906-4073

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/10/2025
- **Last updated:** 10/10/2025