Organization
MOUNTAIN MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE P. DIPRISCO MS (THERAPIST)
(307) 699-0489
Entity
Organization
Contact information
Practice address
78 N MAIN ST UNIT 208, DRIGGS, ID 83422-5141
(307) 699-0489
Mailing address
183 ABBY LOOP UNIT 15, VICTOR, ID 83455-1309
(307) 699-0489
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/26/2023
Last updated
04/26/2023
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