Organization
PSYCHOLOGY SERVICES OF IDAHO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMIE CHAMPION PHD (PSYCHOLOGIST)
(208) 288-1920
Entity
Organization
Contact information
Practice address
2365 E GALA ST, SUITE #2, MERIDIAN, ID 83642-4881
(208) 288-1920
(208) 288-2844
Mailing address
2365 E GALA ST, SUITE #2, MERIDIAN, ID 83642-4881
(208) 288-1920
(208) 288-2844
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7503219
AETNA
ID
Enumeration date
12/11/2006
Last updated
08/22/2020
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