Individual
JAMES WILLIAM CONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D
Contact information
Practice address
2076 S EAGLE RD, MERIDIAN, ID 83642-6707
(208) 955-7333
(208) 955-7330
Mailing address
13389 W BELLFLOWER DR, BOISE, ID 83713-1345
(208) 939-0951
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 202425
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002269500
—
ID
Enumeration date
03/15/2007
Last updated
04/30/2013
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