Individual
DR. CLAY HEROLD WARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D. CLINICAL PSYCH
Contact information
Practice address
3061 S MERIDIAN RD, SUITE 150, MERIDIAN, ID 83642-7962
(208) 631-5063
(208) 887-0950
Mailing address
P.O. BOX 465, KUNA, ID 83634
(208) 631-5063
(208) 887-0950
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY239
ID
103T00000X
Psychologist
PSY-239
ID
103T00000X
Psychologist
PSY239
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00001001591
REGENCE BLUE SHIELD
ID
01
—
1598959322
GROUP NPI
—
01
—
N2399
BLUE CROSS
ID
Enumeration date
06/28/2006
Last updated
11/13/2012
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