Individual
AMY MAUREEN SUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
465 MEMORIAL DR, POCATELLO, ID 83201-4008
(208) 232-7862
Mailing address
500 S 11TH AVE STE 400, POCATELLO, ID 83201-4880
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
SE-203981
ID
Other
Enumeration date
02/27/2023
Last updated
02/25/2025
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