Individual
MICHAEL BRINKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
2076 S EAGLE RD, MERIDIAN, ID 83642-6707
(289) 775-4515
Mailing address
711 WEST VILLAGE LANE, BOISE, ID 83702
(303) 681-8712
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
202751
ID
Other
Enumeration date
04/28/2012
Last updated
08/15/2017
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