Organization
PSYCHOLOGICAL ASSESSMENT SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN L CHRISTENSEN PHD (OWNER/PSYCHOLOGIST)
(208) 233-0150
Entity
Organization
Contact information
Practice address
1246 YELLOWSTONE AVE STE C5, POCATELLO, ID 83201-4373
(208) 233-0150
(208) 233-0159
Mailing address
1246 YELLOWSTONE AVE STE C5, POCATELLO, ID 83201-4373
(208) 233-0150
(208) 233-0159
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SERVICE EXTENDER
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807126900
—
ID
Enumeration date
05/22/2015
Last updated
05/22/2015
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