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Individual

DR. MARGARET CATHERINE GWIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
2901 KOOTENAI ST, BOISE, ID 83705-2326
(208) 343-4855
(208) 343-4856
Mailing address
2901 KOOTENAI ST, BOISE, ID 83705-2326
(208) 343-4855
(208) 343-4856

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1193
OR
103TC0700X
Clinical Psychologist
Primary
PSY202202
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010149803
BLUE SHIELD OF IDAHO
ID
01
N6036
BLUE CROSS OF IDAHO
ID
Enumeration date
08/15/2006
Last updated
12/13/2012
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