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Individual

DR. ALLISON LEE ETNYRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D

Contact information

Practice address
1070 N CURTIS RD, SUITE 210, BOISE, ID 83706-1238
(208) 860-0770
(208) 322-0367
Mailing address
11368 W HICKORY BARK DR, BOISE, ID 83713-1004
(208) 323-9698

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY-202238
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010158559
REGENCE BLUE SHIELD
ID
05
002269500
ID
01
N6135
BLUE CROSS
ID
Enumeration date
03/15/2007
Last updated
06/10/2008
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