Organization
ROGER C EHLERT, PHD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER CLAUS EHLERT PHD (OWNER)
(208) 667-0544
Entity
Organization
Contact information
Practice address
424 E SHERMAN AVE, SUITE 107, COEUR D ALENE, ID 83814-1701
(208) 667-0544
(208) 667-0544
Mailing address
424 E SHERMAN AVE, SUITE 107, COEUR D ALENE, ID 83814-1701
(208) 667-0544
(208) 667-0544
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY56
ID
103T00000X
Psychologist
PY00000622
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010015973
REGENCE BLUE SHIELD OF ID
—
01
—
N0567
BLUE CROSS OF IDAHO
—
01
—
N4700
BLUE CROSS OF IDAHO
—
Enumeration date
03/19/2007
Last updated
07/10/2008
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