Organization
OBSIDAIN MENTAL HEALTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINE THOMAS PMHNP-BC (OWNER/PROVIDER)
(706) 979-1524
Entity
Organization
Contact information
Practice address
1034 MAIN ST, LEWISTON, ID 83501-1842
(706) 979-1524
Mailing address
417 2ND AVE, LEWISTON, ID 83501-2111
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
09/21/2024
Last updated
09/21/2024
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