Individual
DR. RONALD B TYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
6003 OVERLAND RD, SUITE 301, BOISE, ID 83709-3073
(208) 672-8699
(208) 672-9308
Mailing address
6003 OVERLAND RD, SUITE 301, BOISE, ID 83709-3073
(208) 672-8699
(208) 672-9308
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY316
ID
103TC0700X
Clinical Psychologist
PSY3208
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010017563
BLUE SHIELD
ID
01
—
1194837351
GROUP NPI
—
05
—
805455300
—
ID
01
—
N5228
BLUE CROSS
ID
Enumeration date
08/30/2007
Last updated
08/15/2012
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