Individual
RACHEL ANNE ROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
671 E RIVERPARK LN STE 220, BOISE, ID 83706
(208) 344-2071
(208) 344-2075
Mailing address
671 E RIVERPARK LN STE 220, BOISE, ID 83706-6559
(208) 344-2071
(208) 344-2075
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
PSY-202658
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12239758
CAQH
ID
05
—
1710279807
—
ID
01
—
46-1124545
TAX ID
ID
Enumeration date
05/06/2011
Last updated
07/26/2018
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