Individual
HUIYONG CHONG GOODYEAR-FASSIHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1545 E LEIGHFIELD DR STE 100, MERIDIAN, ID 83646-5371
(208) 957-6871
Mailing address
1545 E LEIGHFIELD DR STE 100, MERIDIAN, ID 83646-5371
(208) 957-6871
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
CNP67749
ID
Other
Enumeration date
06/25/2021
Last updated
09/13/2022
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