Individual
DR. CHRISTINE PICKFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1104 N 18TH ST, BOISE, ID 83702-3321
(208) 342-3131
Mailing address
1104 N 18TH ST, BOISE, ID 83702-3321
(208) 342-3131
(208) 383-0329
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
120
ID
103T00000X
Psychologist
Primary
120
ID
103TC2200X
Clinical Child & Adolescent Psychologist
120
ID
103TM1800X
Intellectual & Developmental Disabilities Psychologist
120
ID
103TR0400X
Rehabilitation Psychologist
120
ID
103TS0200X
School Psychologist
120
ID
Other
Enumeration date
02/12/2007
Last updated
01/10/2013
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