Organization
NORTHWEST NEUROBEHAVIORAL HEALTH PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TREVOR ALLEN HALL PSYD (PRESIDENT)
(208) 672-8699
Entity
Organization
Contact information
Practice address
6003 OVERLAND RD STE 301, BOISE, ID 83709-3077
(208) 672-8699
(208) 672-9308
Mailing address
6003 OVERLAND RD STE 301, BOISE, ID 83709-3077
(208) 672-8699
(208) 672-9308
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY202444
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306914643
IND NPI
ID
Enumeration date
12/02/2008
Last updated
12/02/2008
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