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Organization

FULL SPECTRUM THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. SOPHIA RAYE HARMISON MSW (COUNSELOR)
(307) 248-1540
Entity
Organization

Contact information

Practice address
805 N ARTHUR AVE, POCATELLO, ID 83204-2803
(208) 274-5925
Mailing address
5136 HENRY AVE, CHUBBUCK, ID 83202-2207
(307) 248-1540

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary

Other

Enumeration date
09/29/2025
Last updated
09/29/2025
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