Organization
PORTO UNIAO, INC
Active
Other names
Pain Management Psychology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAVERL H. WILHELM PHD (PSYCHOLOGIST)
(208) 676-0926
Entity
Organization
Contact information
Practice address
2180 W IRONWOOD CENTER DR, COEUR D ALENE, ID 83814-2639
(208) 676-0926
(208) 772-5969
Mailing address
212 W IRONWOOD DR STE D311, COEUR D ALENE, ID 83814-1403
(208) 676-0926
(208) 772-5969
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
202060
ID
Other
Enumeration date
03/20/2008
Last updated
06/10/2008
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