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Organization

GLASS HALF FULL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AMANDA STEWART PMHNP-BC (OWNER AND CLINICIAN)
(208) 900-5946
Entity
Organization

Contact information

Practice address
1199 W SHORELINE LN STE 280, BOISE, ID 83702-9102
(208) 593-3263
(208) 957-7437
Mailing address
1199 W SHORELINE LN STE 280, BOISE, ID 83702-9102
(208) 593-3263
(208) 957-7437

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
07/05/2025
Last updated
07/05/2025
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