Organization
WANDA G. FOX
Active
Other names
Tohidu Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WANDA G. FOX LSW,MSW (PROGRAM DIRECTOR)
(208) 265-0745
Entity
Organization
Contact information
Practice address
819 HWY 2 PIONEER SQ. 204, SANDPOINT, ID 83864-0000
(208) 265-0745
(208) 255-1543
Mailing address
819 HWY 2 PIONEER SQ. 204, SANDPOINT, ID 83864-0000
(208) 265-0745
(208) 255-1543
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
LSW-2722
ID
251S00000X
Community/Behavioral Health Agency
LSW-2722
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8068102
—
ID
05
—
8068389
—
ID
Enumeration date
04/06/2007
Last updated
07/15/2008
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