Organization
SIDRAH KHAN PSYCHOTHERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SIDRAH S KHAN LCSW (OWNER)
(208) 447-9526
Entity
Organization
Contact information
Practice address
242 N 8TH ST, SUITE 200, BOISE, ID 83702
(208) 447-9526
Mailing address
4714 N NYSTROM PL, BOISE, ID 83713
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
05/31/2018
Last updated
05/31/2018
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