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Organization

ALPINE RIDGE PSYCHOLOGICAL SERVICES PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL ROBERT THOMAS PHD (CLINICAL PSYCHOLOGIST)
(208) 728-7750
Entity
Organization

Contact information

Practice address
1464 N 805 E, SHELLEY, ID 83274-5049
(208) 728-7750
(208) 728-7750
Mailing address
2184 CHANNING WAY # 119, IDAHO FALLS, ID 83404-8034
(208) 728-7750
(208) 728-7750

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary

Other

Enumeration date
05/12/2025
Last updated
05/12/2025
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