Organization
SYRINGA PSYCHOTHERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLARK EDWARD RICHMAN LCPC (PARTNER)
(208) 946-5242
Entity
Organization
Contact information
Practice address
212 N 1ST AVE, SUITE 203, SANDPOINT, ID 83864-1436
(208) 946-5242
Mailing address
212 N 1ST AVE, SUITE 203, SANDPOINT, ID 83864-1436
(208) 946-5242
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LCPC-4465
ID
251S00000X
Community/Behavioral Health Agency
LPC-4235
ID
Other
Enumeration date
07/08/2011
Last updated
07/08/2011
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