Organization
PSYCHOLOGY CENTER OF IDAHO FALLS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROL VERNON ANDERSON PH.D. ABPP-CN (PRESIDENT, CLIICAL NEUROPSYCHOLOGIS)
(208) 522-3404
Entity
Organization
Contact information
Practice address
3670 S 25TH E STE 2, IDAHO FALLS, ID 83404-4956
(208) 522-3404
(208) 524-1093
Mailing address
3670 S 25TH E STE 2, IDAHO FALLS, ID 83404-4956
(208) 522-3404
(208) 524-1093
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
202288
ID
Other
Enumeration date
09/18/2013
Last updated
09/18/2013
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