Organization
WANDA G. FOX
Active
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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