Individual
COLIN MAHONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SE
Contact information
Practice address
1246 YELLOWSTONE AVE, STE C5, POCATELLO, ID 83201-4374
(208) 233-0150
(208) 233-0159
Mailing address
1246 YELLOWSTONE AVE, STE C5, POCATELLO, ID 83201-4374
(208) 233-0150
(208) 233-0159
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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