Organization
EPIC PSYCHOLOGICAL SERVICES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN J HULBERT PH.D. (OWNER)
(208) 898-8999
Entity
Organization
Contact information
Practice address
2273 E GALA ST, SUITE 100, MERIDIAN, ID 83642-7289
(208) 898-8999
(208) 898-8989
Mailing address
24108 TEN DAVIS RD, PARMA, ID 83660-7212
(208) 898-8999
(208) 898-8989
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY-282
ID
103TC0700X
Clinical Psychologist
PSY-282
ID
103TC1900X
Counseling Psychologist
PSY-282
ID
Other
Enumeration date
04/16/2012
Last updated
04/16/2012
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